The potential role of presenteeism in the association between resilience and intention to continue as a nurse among new graduate and mid-career nurses: A mediation analysis

要旨

Background: Resilience is positively associated with nurses' intention to continue as a nurse; however, interventions to enhance resilience have shown limited success. Although burnout has been suggested as a mediator in this relationship, presenteeism may constitute an earlier and more modifiable factor. Objective: This study aimed to explore whether presenteeism mediates the relationship between resilience and the intention to continue as a nurse among new graduate and mid-career nurses. Design: A cross-sectional observational study was conducted in four university-affiliated hospitals in Japan. Setting: All new graduate nurses and an approximately equal number of mid-career nurses from the four hospitals were targeted for recruitment (252 new graduate and 254 mid-career nurses). Participants: The final analysis included 121 new graduate and 116 mid-career female nurses. Methods: Data were collected via a self-administered online questionnaire that included the Bidimensional Resilience Scale and the Work Limitations Questionnaire-Japanese version to assess presenteeism and intention to continue as a nurse. Mediation analysis was performed using the PROCESS version 4.3 macro in SPSS. Results: < 0.001; 65.7 ± 17.0 vs 75.5 ± 15.1), indicating higher levels of presenteeism. Among nurses with no intention to continue as a nurse, new graduate nurses exhibited lower scores on the time management and mental-interpersonal demands subscales of presenteeism, whereas mid-career nurses showed lower scores primarily on the time management subscale. Mediation analysis indicated that time management subscale may partially mediate the relationships between resilience and intention to continue as a nurse among mid-career nurses (indirect effect β = 0.0164, 95 % confidence interval [0.0004, 0.0471]). Conclusions: Different aspects of presenteeism may play a role depending on the career stage. In particular, presenteeism related to difficulties with time management may mediate the relationship between resilience and mid-career nurses' intention to continue as a nurse. Amid the global nursing shortage, interventions targeting time management among mid-career nurses could be a potential strategy to support nurse retention.

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