Influence of Work Motivation, Work Environment and Job Satisfaction on Turnover Intention of Croatian Nurses: A Qualitative Study

Aim: The purpose of this study was to examine, identify and describe the factors that influence the turnover intention of nurses in Croatia. Methods: A qualitative descriptive phenomenological study was conducted in June 2018. The participants were 20 registered nurses working full time who were employed in different cities in the Republic of Croatia, working in different healthcare institutions and in different medical fields. The data were obtained from interviews and were analysed and interpreted using the content analysis method. Results: During data analysis, four main ideas emerged as follows: job satisfaction, work motivation, psychological factors (individual) and structural factors – work environment. Job satisfaction has been identified as a key factor with direct impact in nurses\u27 turnover intention. Work motivation, psychological factors (individual) and structural factors – work environment does not have a direct influence on the nurses\u27 intention to leave their job, but they have a significant indirect impact through job satisfaction. Conclusion: Recognizing nursing challenges in the healthcare system and the factors which influence the intention of nurses to leave their workplace can help with the development of a clear strategy and retention measures based on the factors that influence the nurses’ turnover intention. (Smokrović E, Gusar I, Hnatešen D, Bačkov K, Bajan A, Grozdanović Z, Placento H, Žvanut B. Influence of Work Motivation, Work Environment and Job Satisfaction on Turnover Intention of Croatian Nurses: A Qualitative Study. SEEMEDJ 2019; 3(2); 33-44

Translation and validation of the Croatian version of the Multidimensional Work Motivation Scale

In the contemporary working environment, it is important to have a referential instrument for assessing and comparing employee work motivation. Multidimensional Work Motivation Scale (MWMS) is a reliable and valid instrument for operationalising the Self-determination theory in practice (SDT). MWMS was previously translated into seven languages, and its validity and reliability were proved in nine different countries. The goal of this study was to translate it in Croatian and test its content and construct validity and reliability (internal consistency, item-total/inter-item correlations and test-retest reliability) in practice. The data was collected through a web survey. The final sample consisted of 141 participants. Our results confirm that the translated instrument is reliable and valid. The items of the translated instrumented loaded on the six factors as expected and showed a good fit to the basic factor structure. The translated version of MWMS could help the management in identifying potential problems related to motivation in Croatian companies. In the contemporary working environment, it is important to have a referential instrument for assessing and comparing employee work motivation. Multidimensional Work Motivation Scale (MWMS) is a reliable and valid instrument for operationalising the Self-determination theory in practice (SDT). MWMS was previously translated into seven languages, and its validity and reliability were proved in nine different countries. The goal of this study was to translate it in Croatian and test its content and construct validity and reliability (internal consistency, item-total/inter-item correlations and test-retest reliability) in practice. The data was collected through a web survey. The final sample consisted of 141 participants. Our results confirm that the translated instrument is reliable and valid. The items of the translated instrumented loaded on the six factors as expected and showed a good fit to the basic factor structure. The translated version of MWMS could help the management in identifying potential problems related to motivation in Croatian companies

BASIC PRINCIPLES OF SURGICAL TREATMENT OF CHRONIC WOUNDS – SHARP DEBRIDEMENT

Porast zdravstvenog standarda u smislu kvalitetnije i učinkovitije zdravstvene skrbi rezultira porastom očekivane životne dobi. U populaciji dolazi do porasta broja starijih osoba. S jedne strane povećana aktivnost starije populacije dovodi do veće incidencije ozlijeđivanja, a s druge strane raste broj komorbiditeta kod takve populacije. Poremećaji cirkulacije, dijabetes melitus, metabolički disbalansi i dr. te smanjeni biološki potencijal regeneracije tkiva ima za posljedicu povećanje broja pacijenata s kroničnim ranama. One su značajan zdravstveno-sociološki i ekonomski problem za društvo. Zahtijevaju značajni angažman medicinskog i nemedicinskog osoblja u prethospitalnim i hospitalnim uvjetima, a značajni materijalni i nematerijalni resursi odvajaju se iz zdravstvene skrbi. Sve to rezultira smanjenom kvalitetom života bolesnika i njegove obitelji, odnosno skrbnika. Debridement je krucijalni medicinski postupak u liječenju akutnih i kroničnih rana. Rezultat debridmana je uklanjanje svih zapreka u rani i neposrednoj okolini rane, a koje opstruiraju odvijanje fi zioloških procesa u cijeljenju rane. Debridement se ponavlja prilikom svakog previjanja rane kada ima indikacija za njegovu primjenu. Postoji više vrsta debridmana. Svaki ima svoje prednosti i nedostatke. Metodu debridmana određuje liječnik ili druga stručna educirana osoba na osnovi karakteristika rane i u skladu sa svojom stručnosti i mogućnostima. U istoj rani mogu se kombinirati razne vrste debridmana, a sve sa ciljem što bržeg i kvalitetnijeg cijeljenja rane.The ever improving health standards in terms of quality and more effi cient health care result in an increase in life expectancy, thus increasing the number of elderly people in the population. A higher level of activity in elderly population leads to greater incidence of injuries, and on the other hand, there is an increasing number of comorbidities. Circulatory disorders, diabetes mellitus, metabolic imbalances, etc. and a reduced biological potential of tissue regeneration result in an increased number of chronic wounds that pose a signifi cant health, social and economic burden on the society. These conditions require significant involvement of medical and non-medical staff in pre-hospital institutions. Signifi cant material and other health care resources are allocated for the treatment of chronic wounds. These conditions result in a lower quality of life of patients and their families and caregivers. Debridement is a crucial medical procedure for the treatment of acute and chronic wounds. The result of debridement is removal of all barriers within and around the wound that obstruct physiological processes of wound healing. Debridement is a repeating process when indicated. There are several types of debridement, each with its advantages and disadvantages. The method of debridement should be determined by the physician or other professional trained person on the basis of wound characteristics and in accordance with their expertise and capabilities. In the same wound, we can combine different types of debridement, all with the goal of faster and better wound healing

APPLICATION OF TOPICAL HEMOGLOBIN SPRAY IN INFECTED POSTTRAUMATIC AND POSTOPERATIVE WOUNDS

Infekcije posttraumatskih i postoperacijskih rana, koje ne cijele, mogu biti ozbiljan problem za traumatiziranog pacijenta sa smanjenim biološkim potencijalom cijeljenja. Također, potreba za specifičnim i individualnim pristupom takvom pacijentu, izazov je i za liječnika. Uporaba topičkog hemoglobina u spreju, koji lokalno u rani djeluje i suportivno, osiguravajući i poboljšavajući fiziološke uvjete zarastanja, dodatno omogućava adekvatno i sigurno cijeljenje kompliciranih inficiranih rana.Posttraumatic and postoperative infective wounds that progress to chronic wounds can pose serious problem for the traumatized patient with reduced biological potential for healing. Also, due to the need for specific and individual approach to such a patient, they represent a challenge for physicians. The use of topical hemoglobin spray (Granulox®) with protective and supportive local action ensures and improves physiological conditions for healing, thus providing additional possibilities for adequate and safe healing of complicated infected wounds

DEBRIDEMENT POSSIBILITIES IN FAMILY MEDICINE

Kronične rane su značajni zdravstveno-sociološki i eikonomski problem za društvo. Zahtijevaju dodatni angažman medicinskog i nemedicinskog osoblja u prehospitalnim i hospitalnim ustanovama, troše značajne materijalne i nematerijalne resurse te dovode do smanjene kvalitete života bolesnika i njegove obitelji, odnosno skrbnika. napretkom medicine i tehnologije na području liječenja rana otvaraju se mogućnosti za provođenje jedne ili više kvalitetnih metoda debridmana od medicinskog osoblja, bez potrebe za stručnim angažmanom bolničkog osoblja. U današnje se vrijeme boljom i sveobuhvatnijom edukacijom medicinskog osoblja, pa tako i timova obiteljske medicine, stvara mogućnost ranog početka kvalitetnog liječenja akutnih i kroničnih rana. Pravodobna indikacija i adekvatna provedba debridmana kao početnog i krucijalnog postupka nameće se kao temeljni postupak prema izliječenju. obavljanjem spomenutog postiže se značajna vremenska korist u procesu liječenja, a izbjegava gubitak dragocjenog vremena utrošenog na naručivanje pacijenta i njegov dolazak do specijalističkih hospitalnih ambulanti.Life expectancy of the population is increasing every day. Accurate and timely diagnosis and appropriate therapeutic approach prevent exacerbation and complications of chronic noninfectious diseases. The result is the increasing trend in life expectancy and the growing proportion of elderly population. The increasing life expectancy is associated with a rising incidence of injuries and failing ill from chronic noninfectious diseases. The increase in comorbidity additionally decreases the biological potential of tissue regeneration, which results in an increasing number of chronic, slow-healing wounds in the elderly population. Chronic wounds represent a signiicant health, social and economic problem for the society. They require additional involvement of medical and non-medical staff in prehospital and hospital institutions, as well as substantial inancial resources. These wounds reduce quality of life of the patient, his/her family or custodian. nowadays, better and comprehensive education of medical staff, including teams of family medicine, make it possible to start early with quality healing of acute and chronic wounds. Timely indication and appropriate use of debridement as the initial and crucial procedure are the basic procedures to support wound healing. Implementing these procedures properly will save precious time in the process of healing, while avoiding wasting time for patient referral and admission to specialist hospital clinics

Translation and validation of the Croatian version of the Multidimensional Work Motivation Scale

In the contemporary working environment, it is important to have a referential instrument for assessing and comparing employee work motivation. Multidimensional Work Motivation Scale (MWMS) is a reliable and valid instrument for operationalising the Self-determination theory in practice (SDT). MWMS was previously translated into seven languages, and its validity and reliability were proved in nine different countries. The goal of this study was to translate it in Croatian and test its content and construct validity and reliability (internal consistency, item-total/inter-item correlations and test-retest reliability) in practice. The data was collected through a web survey. The final sample consisted of 141 participants. Our results confirm that the translated instrument is reliable and valid. The items of the translated instrumented loaded on the six factors as expected and showed a good fit to the basic factor structure. The translated version of MWMS could help the management in identifying potential problems related to motivation in Croatian companies. In the contemporary working environment, it is important to have a referential instrument for assessing and comparing employee work motivation. Multidimensional Work Motivation Scale (MWMS) is a reliable and valid instrument for operationalising the Self-determination theory in practice (SDT). MWMS was previously translated into seven languages, and its validity and reliability were proved in nine different countries. The goal of this study was to translate it in Croatian and test its content and construct validity and reliability (internal consistency, item-total/inter-item correlations and test-retest reliability) in practice. The data was collected through a web survey. The final sample consisted of 141 participants. Our results confirm that the translated instrument is reliable and valid. The items of the translated instrumented loaded on the six factors as expected and showed a good fit to the basic factor structure. The translated version of MWMS could help the management in identifying potential problems related to motivation in Croatian companies

A Conceptual Model of Nurses’ Turnover Intention

The World Health Organisation predicts a lack of 15 million health professionals by 2030. The lack of licenced professionals is a problem that keeps emerging and is carefully studied on a global level. Strategic objectives aimed at stimulating employment, improving working conditions, and keeping the nurses on board greatly depends on identifying factors that contribute to their turnover. The aim of this study was to present a conceptual model based on predictors of nurses’ turnover intention. Methods: A quantitative, non-experimental research design was used. A total of 308 registered nurses (RNs) took part in the study. The Multidimensional Work Motivation Scale (MWMS) and Practice Environment Scale of the Nursing Work Index (PES-NWI) were used. Results: The conceptual model, based on the binary regression models, relies on two direct significant predictors and four indirect significant predictors of turnover intention. The direct predictors are job satisfaction (OR = 0.23) and absenteeism (OR = 2.5). Indirect predictors that affect turnover intention via job satisfaction are: amotivation (OR = 0.59), identified regulation (OR = 0.54), intrinsic motivation (OR = 1.67), and nurse manager ability, leadership and support of nurses (OR = 1.51). Conclusions: The results of the study indicate strategic issues that need to be addressed to retain the nursing workforce. There is a need to ensure positive perceptions and support from managers, maintain intrinsic motivation, and promote even higher levels of motivation to achieve satisfactory levels of job satisfaction