A Review of Factors Affecting Nursing Turnover in Japan
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2019, Vol 12, Issue 3
Abstract
Background: High turnover among Japanese nurses is a significant issue. In 2012, 191,000 nurses joined the profession, while up to 161,000 left. If this trend continues, healthcare service delivery could be severely impacted. However, it is not clear why Japanese nurses leave the profession. There are no systematic reviews clarifying the complex interrelated personal, organizational, and socio-cultural factors that contribute to nurse turnover in Japan. Such insight may help when developing policies in response to this public health issue. Objective: This study aimed to identify factors affecting Japanese nurses’ intention to leave their current position and/or the career as a whole. Methods: A structured review was conducted by researching primary research articles (in English-speaking journals) between 2006 and 2016. Four databases and Google Scholar were used to identify quantitative and qualitative studies focused on describing factors contributing to nursing turnover in Japan. Papers were screened and appraised using appropriate tools. A narrative synthesis was applied to papers included in the review. A thematic analysis was conducted on the findings from each paper. Results: Ten papers were included in the review. Three themes emerged: personal factors, socio-cultural factors, and organizational factors. Relationships between these factors were identified, including associations with burnout and job dissatisfaction. Key factors contributing to job dissatisfaction and burnout included perceived unsuitability to the job, poor work environment, inadequate quality of care, low remuneration, and inexperience. Conclusion: Various strategies may be implemented to address nurses’ intent to leave, including career development and training, flexible working arrangements, improved interpersonal relationships in the workplace, recognition of one’s work, health and wellness courses, and other educational programmers. Generalization regarding each particular nurse’s decision to leave his or her job, or the profession, is difficult to make. The interplay between various subjective and objective factors needs to be considered.At present, the Japanese health system, like most countries, significantly depends on nurses delivering quality care to individuals, families, and communities. Nurses comprise the majority of health professionals in Japan; Table 1 shows that out of 2,029,242 health professionals, almost 70% are nurses (including both registered and enrolled nurses). Thus, nursing shortages can prove costly and detrimental to a nation’s health system [1]. Closely related to nursing shortages is nursing turnover, which can negatively impact the health sector’s capacity to satisfy patient needs and provide quality care [2]. A high turnover rate can affect nurses’ wellbeing and productivity [3]. Hence, for these reasons, a continuous supply of nurses is imperative to the wellbeing and progress of Japanese society. A better understanding regarding nursing turnover is necessary to adequate address this growing problem. Thus, the present paper includes a systematic review of nursing turnover in Japan.
Authors and Affiliations
Yoshiyuki Nagaya
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