Investigating the relationship between the stressors and job leaving intention of health-care centers' managers in Kashan in 2020

Hosein Akbari; Masoud Motalebi Kashani; Reihaneh Ghorbani Pour; Narjes Mogharabi Zadeh

doi:10.4103/iahs.iahs_39_20

ORIGINAL ARTICLE

Year : 2020 | Volume : 7 | Issue : 3 | Page : 149-154

Investigating the relationship between the stressors and job leaving intention of health-care centers' managers in Kashan in 2020

Hosein Akbari¹, Masoud Motalebi Kashani¹, Reihaneh Ghorbani Pour², Narjes Mogharabi Zadeh²
¹ Social Determinants of Health Research Center, Kashan University of Medical Sciences, Kashan, Iran
² Department of Occupational Health, Faculty of Health, Kashan University of Medical Sciences, Kashan, Iran

Date of Submission	27-Apr-2020
Date of Decision	18-May-2020
Date of Acceptance	27-May-2020
Date of Web Publication	26-Aug-2020

Correspondence Address:
Dr. Masoud Motalebi Kashani
Social Determinants of Health Research Center, Kashan University of Medical Sciences, Kashan
Iran

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/iahs.iahs_39_20

Abstract

Aims: Considering the role of management in the performance of the organizations, job leaving is important. Many factors affect on pjob leavening intention of persons, which one of them is stressors. Regarding the importance of this issue, the present study was conducted to determine the relationship between stressors and job leavening intention of health-care centers' managers. Materials and Methods: The present research is descriptive and correlational. The study population was managers of Kashan health-care centers by census method. The tools used in this study were questionnaires of Cammann et al.'s job leaving intention and stressors. Data were analyzed using SPSS16 software with methods of correlation and regression. Results: Results indicated a relationship between familial stressors, and finding a new job was significant (P = 0.016). Furthermore, the relationship between stressors and health-care centers was significant (P < 0.05). However, the relationship between stressors and job leaving intention was not statistically significant (P > 0.05). Furthermore the frequencies of occupational stressors, social stressors, cultural stressors, economic stressors, familial stressors, personal stressors and total stressors were 51.1%, 44.5%, 30.7%, 22.6% and 26.3% respectively.. Conclusion: As mentioned by the results, health-care centers' managers were exposed to many stressors. Among these factors, the frequencies of occupational, social, cultural, and economic stressors were more than other stressors, eliminating that these factors can lead to the maintenance of physical and mental health of managers and enhancement of their work efficiency.

Keywords: Case managers, hospitals, stress psychological

How to cite this article:
Akbari H, Motalebi Kashani M, Ghorbani Pour R, Mogharabi Zadeh N. Investigating the relationship between the stressors and job leaving intention of health-care centers' managers in Kashan in 2020. Int Arch Health Sci 2020;7:149-54

How to cite this URL:
Akbari H, Motalebi Kashani M, Ghorbani Pour R, Mogharabi Zadeh N. Investigating the relationship between the stressors and job leaving intention of health-care centers' managers in Kashan in 2020. Int Arch Health Sci [serial online] 2020 [cited 2023 Mar 27];7:149-54. Available from: http://www.iahs.kaums.ac.ir/text.asp?2020/7/3/149/293496

Introduction

Health-care managers have a major impact on the improvement of health-care practices and staff supervision. Therefore, a manager's resignation is considered as an important issue.^[1],[2] As a result, attracting and retaining skilled managers have become an increasingly important and urgent issue for the municipalities in Sweden.^[3] Organizations try to maintain their effective force and prevent them from leaving their jobs.^[4] The job leaving tendency is the intention of individuals to leave the organization that affects the goals of the organization.^[5],[6] Previous studies have shown that job leaving intention is a strong predictor of actual job leaving.^[7] Leaving a job places heavy direct and indirect costs on the organization.^[8] The direct cost is about 150%–200% of a person's monthly salary, which includes the cost of employing and training a new person.^[9],[2] Moreover, indirect costs include reducing work conscience, losing capital, and weaken employees' morale.^{[5],[10],[11]} Leaving a job can happen when people's expectations are not met, and there is a role conflict; in that case, people are not fulfilling their obligations, behaving against the interests of the organization, and finally leave the organization.^[6],[12] Of course, people do not leave the organization at once, but job leaving happened gradually.^[10] Organizations that can predict the factors affecting job leaving will be able to use effective methods to maintain their personnel; one of these methods is correct management. Like, most of the world's leading organizations such as NASA, the New York Times Magazine, the airline KLM, and BMW company use the correct management approach to maintain employees.^[13],[9] Numerous studies have shown that factors such as lack of support from senior managers, no contact with patients, and organization environment can be effective factors in intention job leaving managers of health-care centers. In addition, stressors can be one of these factors.^[3],[14] Stress causes persons in terms behavioral, psychological, physiological reaction; it also causes physical and mental disorders in the person.^[15],[16] Tasks such as planning, setting time for doing tasks and budgeting; Management has become a stressful job; which This stress can interfere with their making decision.^{[17],[18],[19]} Some health-care managers described how they had no energy left when they got home from work.^[1] However, managers leave their positions for other reasons as well. In Sweden, research has shown a high rate of voluntary resignation among government managers.^[1],[3] Skagert et al. in a research named “a prospective study of managers turnover and health in a healthcare organization” found that 26% and 40% in a sample of 216 health-care managers in Sweden were dismissed for 2 and 4 years, respectively, and annual managers' turnover rates range from 5% to over 50%. Stroh et al. in a study of managers' job leaving in Chicago, among 615 male and female managers, found that 26% of female managers and 14% of male managers left their job and also the reason for women leaving job was familial stressors.^[20] Skytt et al. in a study about reasons to leave their posts of nurse managers, which was done on 32 first-line nurse managers, concluded that reasons to leave were personal, organizational, as well as lack of support from and relations to the head of the department. Difficult situations were unclear conditions, lack of support from supervisors, implementation of changes, staff matters, and economy and lack of opportunities for promotion and training.^[21] Tongchaiprasit and Ariyabuddhiphongs in a study about turnover intention among hotel chefs which was done on 145 hotel chefs in Thailand concluded that job stress affects intention to leave and intention to leave is a predictor of actual job leaving.^[22] According to Several studies are predicted which many retirees will be EU government managers in the coming decade.^[23] Studies about job changing intention, especially in the public sector, are limited compared to the private sector. Since the public sector is unable to provide the same level of benefits to the private sector, so job leaving the public sector is more than private.^[3] Some managers believe which the reasons of job leaving intention are high-stress management, and there are few studies that have examined health-care managers' stressors and their impact on their intention to leave. Therefore, in this study, we decided to determine the relationship between stressors and job leavening intention of health-care centers' managers and take a step toward controlling stressors and decreasing job stress.

Materials and Methods

The present research is correlational. The statistical population of the study were included all managers of health-care centers in Kashan, Isfahan province, Iran. Manager defines as people who are responsible for one or more people. Required information for this study was collected by field and using questionnaire. The criterion to participate in the study was having at least 1 year of management experience. Furthermore, exclusion criteria studies were having chronic physical and mental problems and losing relatives in recent months. After approval of the proposal, first we went to health care centers and offered managers the essential explanations for completing the questionnaire. Each of the managers who were fully satisfied completed the questionnaires. Finally, 137 managers participated in the study. Statistical analysis was performed using SPSS 16 software (SPSS Co., Chicago, ILL, USA). Data using statistical methods of average descriptive and standard deviation and analysis of Pearson correlation coefficient and regression were analyzed.

Research tools

In this study, researcher-made questionnaires were used to collect the demographic data of individuals including age, gender, marital status, education, work experience, management experience, and income, and two questionnaires of job leaving intention and stressors were used to measure other variables in the study.

Cammannet al.'s job leaving intention questionnaires^[24]

The Job Intention Questionnaire consists of 3 items and its responses are scored on a 7-point Likert scale from 1 (strongly disagree) to 7 (strongly agree). In this study, the translation version of Arshadi et al. was used. Cammann et al. reported the reliability of this questionnaire 0.78 by Cronbach's alpha. Arshadi et al. obtained its validity 0.61 and its reliability by Cronbach's alpha 0.79. In the research of Moghadam et al., the reliability coefficient of the present questionnaire was 0.88.^[25]

Stressor questionnaires

The validity and reliability of this questionnaire were investigated by Mirsamadi and Jafarpour.^[14] The stressor questionnaire was taken from the Luthans questionnaire which was compiled by Abtahi and Alvani (1992) with some changes, and its validity was confirmed. Furthermore, in research by Mirsamadi and Jafarpour (2006), its reliability by a 10-day retest with 10 managers was obtained 0.73. The questionnaire consists of 44 questions: 9 questions about personal stressors, 8 questions about familial stressors, 18 questions about occupational stressors, and 9 questions about social, cultural, and economic stressors, and the answers are in a 5-point Likert scale from 1 to 5. The scores are calculated in four parts for each individual. The highest score is 220 and the lowest is 44. People with a score above 132 are considered stressful, and any question in people who have a mean above 3 is considered an important stressor.^[14]

Results

The present study investigated 137 managers of health-care centers in Kashan. Of these, 79 (57.7%) were male and the rest were female. Most of the participants were married (89.1%) and older than 40 years (53.3%). In terms of education level, 7 (5.1%) had associate diploma, 62 (5.3%) BSc, 30 (21.9%) MSc, 23 (16.8%) had PhD, and the rest were medical PhD. Most managers had more than 10-year (76.6%) work experience and <5-year (70.8%) management experience. In terms of income level, 53.3% of managers were under 50 million rials, 20.4% of them were 50–100 million rials, and the rest were over 100 million rials.

[Chart 1] shows the frequency of stressors among managers. Occupational stressors (51.1%) had the most frequency and frequency of other stressors were social, cultural and economic stressors 44.5%, familial stressors 30.7%, personal stressors 22.6%, and total stressors 26.3%, [Chart 1].

[Chart 2] shows the frequency of stressors based on health-care centers. The relationship of personal, social, cultural, economic, and occupational stressors with health centers was significant (P < 0.001) [Chart 2].

The job leaving intention includes three subscales: thinking about job leaving intention, finding a new job, and job leaving intention soon.

[Chart 3] shows the frequency of job leaving intention based on health-care centers which are in the order of frequency: Shahid Beheshti Hospital, Matini, Naghavi, Kargarnejad, and Central Emergency [Chart 3].

[Table 1] shows the relationship and frequency of stressors with demographic and occupational variables. There was a significant relationship between management experience with social, economic, cultural stressors; also, the relationship between marital status and familial stressors was significant (P < 0.001) [Table 1].

Table 1: Frequency of health-care center managers' stressors based on demographic and occupational variables of managers

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The mean and standard deviation of the research variables are listed in [Table 2]. The relationship between finding a new job and familial stressors was significant (P = 0.016) [Table 2].

Table 2: Mean and standard deviation of job leaving intention scores based on stressor variables of managers

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In [Table 3], the relationship and frequency of job leaving intention based on demographic and occupational variables of managers were mentioned. There was also a statistically significant relationship between job leaving intention soon with income and age (P < 0.001) [Table 3].

Table 3: Frequency of job leaving intention based on demographic and occupational variables of managers

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Discussion

The present is a research descriptive and correlational whit purpose was to investigate the relationship between job leaving intention and stressors. This study examined the relationship between stressors including personal, familial, social, cultural, economic, and occupational stressors with job leaving intention (which includes three subscales of thinking about job leaving intention, finding a new job, and job leaving intention soon). The results showed that there was a significant relationship between finding a new job and familial stressors (P = 0.016). Although the frequency of occupational stressors was high among managers, no significant relationship was found between job stressors and job leaving intention (P > 0.05). This finding is inconsistent with the study of Mondalizadeh and Javaheri.^[26] probably this result was because of:

• poor economic conditions

• lack of facilities and budget

• high stress in health-care centers

• lack of support from senior managers

• responsibility for patients

despite the managers' dissatisfaction with the current situation; however, considering the labor market conditions, they did not intend to leave their jobs.

There was a significant relationship between job leaving intention soon and income (P < 0.001). As income increased, the job leaving intention was less likely. This finding is probably because of : Whatever income level of individuals higher, the same proportion of economic factors that cause stress in managers (such as inflation, problems related to cost) are reduced; and the person performs his duties calmly and less anxiously. These people are committed to the organization and are moving forward the goals of the organization, so they do not intend to leave the job. Furthermore, the relationship between age and job leaving intention soon was significant (P < 0.001); this finding was in contrast to Dashtgrad et al. (2018) study.^[27] This difference could be attributed to different measurement tools and different statistical populations. As age increases, also job leaving intention increases. This finding is probably ascribable to the fact that as people get older, the stressors they deal with increase. These factors affect the physical and mental health of managers and cause their fatigue and job leaving.

There was also a significant relationship between management experience and stressors, which was in line with the results of Khoeenezhad et al. which was done a study of school principals (P = 0.019).^[28] However, it is inconsistent with the study of Ghafourian et al.^[29] With increasing management experience, the stressors which caused stress in managers have become alleviated. This result may be on account of the fact which as work experience of people is increasing, their ability to do duties and control the condition increases. Therefore, the factors that previously caused stress are reduced; also, their job leaving is reduced.

The relationship between stressors and gender was not significant. This finding is consistent with the results of other studies in this area (P > 0.05).^{[28],[30],[31]} This finding is in line with the results of two studies by Yaghoubi et al. (one in Isfahan hospital managers and the other in Isfahan nursing managers were done), and the study of Alaei which was done in Ilam school principals.^{[19],[30],[31]}

Furthermore, the relationship between stressors and education was not statistically significant. This finding is in line with the results of the study of Alaei.^[31] Probably, the reasons for this include more marital problems with a married person and disagreement with a spouse.

In the present study, the prevalence of occupational stressors was 51.1%. This result is close to the result of Soori et al. (49.5%) which was done in car manufacturer companies.^[18] There was a significant relationship between stressors and health-care centers (P = 0.002).

In general, stressors in health-care centers were in the order of frequency: Shahid Beheshti Hospital, Naghavi, Kargarinejad, Matini, and Central Emergency.

Limitations

One of the limitations of this study was that some managers may not have answered the questions honestly. Future studies should be conducted using an interview with a psychologist. Another limitation was leave and inaccessibility to managers that led to a decrease of the study population.

Conclusion

In general, there was a statistically significant relationship between stressors and job leaving intention (P > 0.05). The frequency of occupational stressors was more than other factors (51.1%). This finding indicated that managers suffered from occupational stressors and by removing them can keep managers healthy and enhanced their work efficiency. Furthermore, between health-care centers, Shahid Beheshti hospital regarding stressors and job leaving intention was in undesirable condition.

Acknowledgment

We would like to thank the participating health-care centers' managers and other people for their assistance in collecting data.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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