Online Program

Psychosocial factors related to intention to stay as a nurse in urban and rural areas in Japan

Tuesday, November 3, 2015

Miho Satoh, Ph.D, RN, PHN, Tokyo Health Care University, Tokyo, Japan
Kyoko Asakura, PhD, RN, PHN, Graduate School of Medicine, Division of Nursing Education and Administration, Tohoku University, Sendai, Japan
Ikue Watanabe, PhD, RN, Tohoku Fukushi University, Sendai, Japan
Background and Aim

Nurse turnover today is a serious problem globally. In Japan, hospitals employ various strategies to secure nursing personnel. This ongoing prospective study aims to identify factors influencing intention to stay as a nurse for hospital nurses in urban and rural areas in Japan.


A self-report questionnaire was distributed in September 2013 (baseline) and March 2014 (Time 1: T1), examining individual attributes, occupational commitment, effort-reward imbalance, cumulative fatigue, self-rated health, and intention to stay as a nurse. Hierarchical logistic regression analysis was performed to determine factors influencing intention to stay by area.


Of 3,978 nurses, 608 completed both questionnaires (242 urban; 366 rural). In urban areas, baseline intention to stay was an important predictor of T1 intention to stay (OR = 56.03, p < 0.001), which moderated the effect of cumulative fatigue and affective occupational commitment. Effort-reward imbalance was not related to T1 intention to stay. In rural areas, effort-reward imbalance influenced T1 intention to stay through adverse health. Self-rated health, continuance occupational commitment, and intention to stay at baseline strongly predicted T1 intention to stay (OR = 2.44, p < 0.01; OR = 1.23, p < 0.01; OR = 6.47, p < 0.001). Responsibility for elder care also affected T1 intention to stay (OR = 0.30, p < 0.05).


The factors influencing intention to stay as a nurse differ between urban and rural areas. Nurse retention strategies should be implemented that reflect the characteristics of nursing staff and the region.

Learning Areas:

Occupational health and safety

Learning Objectives:
Describe the psychosocial determinants of intention to stay among nurses in two areas. Discuss how nurse retention polices are designed to reflect regional sociocultural characteristics.

Keyword(s): Nurses/Nursing, Occupational Health and Safety

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the co-principal investigator of this research and am responsible for the literature review, study conceptualization, and data analysis for this abstract.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.