Transcript Presentstion_2013_07_29

Health Related Quality of Life:
Prevalence and Its Associate on the
Intention to Leave Nursing Career.
Nittaya Phosrikham
Contents
1
BACKGROUND
2
MATERIALS AND METHODS
3
RESULTS
4
DISCUSSIONS
BACKGROUND
 Health Related Quality of Life (HRQOL) is an
important health outcome indicator
 Previous study : HRQOL of nurses was lower than
that in general population
Wu et al. 2011==> Nurses
in China
He et al. 2012 ==>Doctors and
nurses in China
***In cortex of the Registered Thai Nurses
has not been studied.
BACKGROUND
HRQOL in nurses is affected by many factors,
Not clarified about its effect on another
factors, including Intention to Leave (ITL) of
nursing career.
Relationship between ITL with many factors
such as QWL, burnout, stress and depression
*** HRQOL has been not clarified and in cortex of
the Registered Thai Nurses has not been studied.
Research Question and Objective
What is the prevalence
of HRQOL among
registered nurses (RNs)
in Thailand ?
RQ
What is the magnitude of
effect of HRQOL on the
intention to leave a nursing
career?
Objective
To investigate the
prevalence of HRQOL
among registered nurses
(RNs) in Thailand
To investigate the
association of HRQOL
and intention to leave in
a nursing career among
Registered Thai Nurses
in Thailand
MATERIALS AND METHODS
Study Design
- A cross sectional study, part of the first
wave survey of Thai nurses cohort study
conduct 2010.
Study outcome
-Primary outcome : Health Related Quality
of Life (HRQOL)
-Secondary outcome : Intention to Leave
(ITL) nursing career.
Outcome measurment
Health Related Quality
of Life (HRQOL) was
assessed by Euroqol5D (Eq-5D)
normal, mild,
moderate,
severe states
Intention to Leave (ITL)
a nursing career within
1-2 years or after 2 years
- good health
-fair or poor
health”
- ITL”
- No ITL”
MATERIALS AND METHODS
Covariate : Gender, Age, Marital status, Highest education
attainment, Current major work position, Workplace,
Liabilities, Sufficiency of monthly income, Scheduled time,
Schedule usually worked in main nursing job, Working
experienced and Having musculoskeletal disorders.
Statistical analysis
Descriptive
Statistics
: Frequency , percentage
: Mean, Standard deviation,
Median, Minimum, Maximum
Bivariate Analysis : Crude ORs
Multiple Analysis : Adjusted ORs
STATA
version
12.0
RESULTS
Total number of registered nurses
(N = 142,698)
Sampled and mailed the
questionnaires (n = 50,209)
18,200 could not be
contacted due to wrong
addresses
Excluded (n = 2,125)
Contactable (n= 30,209)
Returned questionnaires and
enrolled (n= 18,756)
Aim 1
Currently in nursing career
(n = 16,631)
Aim 2
Currently in nursing career
(n = 16,316)
- Currently not involved in
nursing career (n = 1,709)
- Missing data on current
working status and/or
health related quality of life
(n = 416)
Excluded Missing data
on intention to leave in
nursing career
(n = 315)
RESULTS
- Female : 96.8%
- Married: 60.8%
- Mean age: 43.09.4 years old (ranged: 18.6-65.3)
- Bachelor’s degree: 57.3%
- Practical nurses: 67.4%
- Workplace: Hospital (83.0%)
Demographic
Characteristics
- Sufficiency of monthly income: Saving (35.3%)
-Schedule time: 8 hr per shift (94.4%)
-Schedule usually worked in main nursing job :
Regular daytime shift (51.0%)
- Mean of Work experience: 20.5.09.6 years
RESULTS
Prevalence of HRQOL
Fair or Poor state
43.8%
95%CI: 43.1 to 44.6
Good state
56.2%
95%CI: 55.4 to 56.9
RESULTS

DISCUSSIONS
* The prevalence of Fair or Poor health state among
registered nurses was 43.8% (95%CI: 43.1 to 44.6) ,
Thai population, 54.2%
* Overall mean HRQOL score HRQOL score of 0.693
(standard deviation = 0.119).
- nurses possess more knowledge and skills for
disease prevention
- nurses access health care service more
conveniently than the Thai population (70% of sample
lived in rural area)
DISCUSSIONS
* Nurses of the other country found that the previous
HRQOL study which was assessed by Euroqol-5D
(Eq-5D) can’t be compared
* According each dimension : percentage of nurses who
having some problem was quite high in pain/
discomfort dimension
- 67.4% were currently practical nurses who
having job characteristic which use more physical effort
DISCUSSIONS
* There was association between HRQOL and intention
to leave nursing career
- not controlled by other factors that there was
association (OR = 0.15; 95%CI: 0.11 to 0.21; p-value
<0.001
- adjusted for another factors that there were
associated (OR = 0.17; 95%CI: 0.10 to 0.18; p-value
<0.001) (high protective factors )
* The findings indicate the need to improve the
health related quality of life.
Strength of the study : a large of sample sizes which
could accurately represent the situation of health
related quality of life and intention to leave nursing
career among Thai registered nurses.
Limitation of the study
- The questionnaires was created for several
research purposes which was not specific in this study.
- Self-administration questionnaire could create
information and recalled bias.
- The cross sectional design cannot indicated the
causal factors and could explain only the relationship.
CONCLUSION
The prevalence of fair or poor health state was
43.8% (95%CI: 43.1 to 44.6) and Overall mean HRQOL
score HRQOL score of 0.693 (SD = 0.119).
Health related quality of life associate to intention
to leave a nursing career : adjusted for another factors
that there were associated (OR = 0.17; 95%CI: 0.10 to
0.18; p-value <0.001
These finding should encourage nursing
administrators and policy makers to deliver focused
interventions to reduce nurses’ intention to leave
nursing career through improving the health related
quality of life dimensions.
Recommendations
Recommendation for organization: organization should
encourage nursing administrators and policy makers
to reduce nurses’ intention to leave nursing career.
Recommendation for future study: should be conducted
to determine causes of health related quality of life
and practical intervention program to improve
improving the health related quality of life.
ACKNOWLEDGEMENTS
- Human Resource for Health Research and
Development Office, Health System Research Institute,
the International Health Planning and Policy, and the
Thailand Nursing and Midwifery Council
- Prof. Dr. Bandit Thinkamrop
- Dr.Cameron Hurst
- Miss Wilaiphorn Thinkamrop
- Dr. PH Batch 4
- My classmate