Organizations have a major dilemma on their hands, and they need to address the burnout symptoms that lead employees to leave their teams. Incompetent managers are another issue that often drives employees to other positions, as they're forced to deal with someone who doesn't do their job properly every day.
A toxic work environment, stressful routines and other negative environmental factors can lead employees to emotional and mental exhaustion. The emotional exhaustion can come through in many ways, such as disengaging with the rest of the team, having a short temper or being overly critical of other employees' ideas.
When the higher-ups start to complain about lower revenue or poor customer satisfaction, they overlook the role that they play in the situation. By understanding the reasons that burnout causes employees to look elsewhere for a job, you can start to shore up the weak points in your company.
Recruiting talented people are always a critical stage for an organization and is also one of the key to success for a company. A satisfactory working environment includes worker friendly, good salaries, involvement in decision-making and recognition for good performance by employees.
Job satisfaction can be influenced by a variety of factors, for example, pay practice, quality of one's relationship with their supervisor, quality of the physical environment in which they work whereby turnover refers to the rate at which organizations and companies losses and gains its employees. Job satisfaction and turnover basically relates by which job satisfaction has directly effect on the turnover (MacLeish, 1988). The main target of all organizations is to improve their productivity and, consequently, their performance and, thus, to become more competitive and gain a larger market share.
HRM departments or managers of accounting organizations, despite the size of the company or the volume of activities, should be seriously concerned about their employees' needs and work towards establishing satisfactory working conditions to enhance satisfaction (Capella, 2000). Discussion Turnover Companies are finding it difficult to retain its employees. Turnover defines a rate of which employer's losses and gains its employees.
Structural equation modelling is adopted so that the qualitative and quantitative analyses can explore the relationship among job burnout, satisfaction and turnover intention. Health and medical personnel play a seminal role in fulfilling the healthcare needs of the entire population; therefore, a robust allocation of human resources maintains the health system running smoothly and also guarantees people accessing to healthcare priority equally.
1 Unfortunately, the current out of balance between healthcare staff supply and demand has challenged this priority and triggered a global problem of continual brain drain. As a developing country with a huge population, China’s shortage of health workforce has posed one of the major obstacles to primary healthcare services.
3 To make matters worse, primary healthcare workers are generally confronted with the challenge of high turnover intention, which has become a social problem to be reckoned with. 4 Results of a survey show that from 2010 to 2016, the proportion of Chinese primary healthcare staff decreased from 44% to 33%.
5 Moreover, the average turnover rate of nurses in first-class tertiary hospitals is 5.8% in China, which goes up to 8%–10% in economically advanced regions like Shanghai and Guangzhou. 6 Under this circumstance, the turnover intention has been an important and popular study subject in psychology and management field.
Turnover intention reflects an individual’s conscious and deliberate willfulness to quit one’s job or organization within a certain period, which would possibly pose a major problem in healthcare system resulting in a high turnover rate. In the late 1980s, Pines and Bronson defined job burnout as a state of physical, emotional and mental exhaustion.
16 Job burnout can be categorized into three dimensions, including emotional exhaustion, depersonalization and the sense of reduced personalized accomplishment. In other words, job satisfaction refers to an individual’s cognitive or effective evaluation of his or her occupational duties, presenting the extent people like the job and reflecting the effective judgements people hold toward their work condition.
19 20 Numerous studies have repeatedly verified that job satisfaction is inversely related to turnover and intent to leave. Taken together, the theoretical framework used in this study originated from researches suggesting that turnover intention maybe both related to satisfaction and burnout toward the job.
As shown in figure 1, we tested this theoretical model with the data from primary healthcare staff in central China to explore the mediating effect of satisfaction. In this investigation, we used survey research methods to make sense of the job burnout, satisfaction and turnover intention of primary healthcare staff.
The sample size was estimated with the average detection rate of burnout in China with the equation:, where is 0.05, is 0.08 and p is 55%. All participants were recruited face-to-face from 29 primary healthcare institutions in Huang pi district by our research group.
Participants fulfilled electronic questionnaires with a mobile application, or they orally answered questions and the results were synchronously typed in. In the first stage, an empirical study was processed to optimize items in each scale, including discrimination tests and collinearity diagnostics.
Last, the effect of job burnout on turnover intention via satisfaction was examined using a structural equation modelling with maximum likelihood estimation. A total of 1300 electronic questionnaires were sent out, and 1279 eligible participants left after deleting those with uncompleted or suspected unreal answers.
As shown in table 1, over half of the participants (66.50%) were women; 79.12% were married; 43.55% were physicians and 41.83% were nurses; 63.02% earned 2001–4000 Chinese Reminds (RMB, US$290.97–581.65) per month. The median (range) score of satisfaction, job burnout and turnover intention was 52 (13–65), 22 (9–37), and 12 (5–25).
The model finally fits the data acceptably (=7.889, GFI =0.986, CFI =0.994, RM SEA =0.073, NNI =0.994, IFI =0.994). In the Adjusted Burnout Scale, we omitted the items from 15 to 17, 19 and 21 because of a low distinguish ability in discriminant analysis.
Besides, the adjusted burnout also has a good validity conducted by EFA and CFA (=8.395, GFI =0.993, CFI =0.994, RM SEA =0.076, NNI =0.994, IFI =0.994). The Cranach’s coefficient for the remaining four items (=0.865) indicated good internal consistency reliability.
Table 2Pearson correlation among job satisfaction, burnout and turnover intention of primary healthcare workers The hypothetical model yields satisfactory values (GFI =0.947, CFI =0.975, RM SEA =0.067, NNI =0.971, IFI =0.975), indicating credible data fit.
Educational level, monthly income and hire form showed a direct (r =0.084,–0.037, 0.048, respectively) and indirect (r =0.008,–0.018, 0.015, respectively) effect on turnover intention. Also, age and nigh shift could affect turnover intention through job burnout with the standard path coefficient of 0.111 and 0.062.
This model also showed a good fit to the data: GFI =0.947, CFI =0.971, RM SEA =0.054, NNI =0.963, IFI =0.971. This study was conducted to investigate the mediating effect of job satisfaction in the relationship between job burnout and turnover intention among primary medical staff in Huang pi District where the medical resources and clinical ability represent the averaged level in China.
Our study additionally demonstrated that the prevalence rate of job burnout and turnover intention was, respectively, 18.69% and 26.04%. In line with earlier studies, our results recognized that job burnout positively predicted turnover intention with an explanatory power of 94.73%.
28 Hences, hospital managers must think about the role conflict and the way to solve emotional exhaustion and reduced personalized accomplishment. Our results also found that satisfaction could directly or indirectly affect turnover intention with a relatively limited effect.
That is to say, the fundamental reason for turnover tendency is job burnout while only 5.32% is related to low satisfaction. Therefore, the improvement of working conditions, welfare, advanced-learning opportunities and reward mechanisms is worthy of concern but limited effect.
The effective ways to solve this problem are to understand how burnout generates, focus on staff’s physical and mental changes, and do in science. Apart from it, the turnover intention was noted to be affected by age, education level, monthly income, hire form and night shift directly or through the mediators of satisfaction and burnout in our study.
Primary healthcare institutions generally play an essential role in medical providing and safeguarding among the broadest masses of people. But most of the basic healthcare staff in China still encounter low salaries, less independence, insufficient social support and few promotion prospects, which could lead to job burnout, unsatisfaction even turnover.
35 It is necessary to adopt a reasonable mechanism of performance incentive and financial management, to regulate and optimize nigh-shift works, and to set up a good academic atmosphere at the same time. Besides, more focuses need to raise on healthcare providers’ psychological states, especially this youth with high educational background and academic qualification.
Although this study contributes to the knowledge base of the turnover intention related to job burnout and satisfaction, it does have several limitations. First, causal relationships among turnover, burnout and satisfaction should be cautiously interpreted as this is a cross-sectional study.
Third, other potential predictors such as work stress, social support and mental health were not captured in our questionnaire. Age, education level, monthly income, hire form and night shift also influence the turnover intention, hence, relative measures can be taken to promote enthusiasm and satisfaction thus decreasing the turnover rate.
In the face of fierce competition, burnout is common among new generation of employees. Burnout can’t be ignored as it will cause negative effects, high turnover rate, low work performance.
This issue is particularly important in the context of China’s manufacturing transformation and upgrading. The transformation and upgrading of the manufacturing industry can’t be separated from the input and innovation of the new generation of skilled workers.
Therefore, to reduce turnover and improve performance caused by burnout has become an important issue in human resource management. However, the modern manufacturing industry is demanding increasing pressure, and workers are prone to burnout.
In recent years, the research of the new generation of employees, many scholars believe that the career commitment of the employees determines their work attitude and behavior, so the career commitment is associated with job performance and turnover intention, if the career commitment and work values is similar, it can stimulate the employee’s behavior. Burnout is a long-term reaction that an individual can’t cope with the job stress effectively.
Study of the domestic and foreign scholars show that individuals, who feel anxious, tired, unable to concentrate, and unable to control their work will make mistakes in their work and lead to lower performance . Previous studies have shown that the burnout one who feel unhappy with job and have a lot of trouble at work and bad relationship with colleagues can lead to higher absenteeism rates and a greater likelihood of leaving the post .
In general, the higher the burnout, the more likely to hate the current occupation, so we think that the high burnout individuals, the more will shake their professional pursuit, resulting in lower career commitment, thereby reducing the work of the input; and low burnout of the individual will be more and more his/her career choice, and become more focused on professional activities, more input in the work, also they will use a positive and optimistic way to solve problems in the work, so the higher task performance. Career commitment mediates the negative effect of burnout on task performance.
Domestic and foreign scholars generally believe that the relationship between career commitment and turnover intention is negatively correlated, that is, the decline in professional commitment will lead to increased turnover intention. The study found that career-related attitudes would have a certain impact on the loss of business people.
Career commitment mediates the positive effect of burnout on turnover intention. As individuals’ career commitments reflect their love and identity of their work, individuals with higher career commitments, if they have a strong sense of innovation, will take the initiative to carry out the work and prefer to try creative ways of working, which may enhance their task performance; at the same time, with a strong professional pursuit of individual, once he/she have the innovative work values, will cherish the opportunities offered by the enterprise and looking forward to more job skills, thereby reducing their willingness to leave.
On the other hand, workers who tend to work with lower innovation orientation, even if they have a certain career pursuance, may be more willing to work step by step, and their task performance improvements will be constrained; and under innovative work pressure, there is no sense of innovation and enthusiasm employees will reduce their degree of liking for their careers, thereby deepening their willingness to leave. Innovation orientation moderates the relationship between career commitment and task performance.
Innovation orientation moderates the relationship between career commitment and turnover intention. We selected 223 employees on the car assembly line and 45 of their direct supervisors to participate in the study.
Career commitment was measured according to an 8- item questionnaire developed by Beau (1985) . Supervisors reported on these items, so the data collected in this way exclude the staff in charge and are more objective and impartial.
Because demographic variables may influence employees’ job attitudes and performance (van der Vent & Gunderson, 2005), we controlled for participants’ age (in years), the highest educational attainment (“1” = below high school, “2” = high school, “3” = college, “4” = undergraduate or above), and organizational tenure (in years). Table 1 provides descriptive statistics for all variables analyzed in this study.
The expected five-factor solution (burnout, task performance, turnover intention, career commitment and innovation) displayed adequate fit with the data ( 2 = 402.03, CFI = 0.96, MR = 0.05, RM SEA = 0.06). This study uses SPSS 22.0 software to analyze the data by using the method of regression analysis; the results are shown in Table 2.
Regression analysis of task performance and turnover intention as the dependent variable. We can conclude that burnout has a significant negative impact on job performance (beta = 0.24, p < 0.001) from model 4, so hypothesis 1a is supported.
Model 10 shows that burnout has a significant positive impact on turnover intention (beta = 0.68, p < 0.001), hypothesis 1b is supported. By model 4, burnout has a significant negative impact on job performance (beta = 0.24, p < 0.001); the model 2 shows that burnout has a significant negative impact on career commitment (beta = 0.58; p < 0.001); but by the model 6 shows that when working together to do regression performance on burnout and career commitment, career commitment coefficient is not significant, in order to further test the hypothesis of 2a, this paper uses Hayes (2013) design of the SPSS plug-in for Bootstrap mediator test.
Select the Bootstrap 5000 samples, using the method of error correction, select the 95% confidence interval, the results show: the test results intermediary contains 0 (LOCI = 0.0888, ULC = 0.0794), shows that the mediating effect of career commitment is not significant, so that hypothesis 2a is not supported. Significant effects of burnout on model 2 career commitment (beta = 0.58; p < 0.001) and model 12 career commitment has a significant impact on turnover intention (beta = 0.35, p < 0.001) provides some support for the hypothesis 2b, in order to further test the hypothesis 2b, still using Hayes design of the SPSS plug-in for Bootstrap intermediary variable test.
Select the Bootstrap 5000 samples, using the method of error correction, select the 95% confidence interval, the results show: the test results intermediary does not contain 0 (LOCI = 0.0957, ULC = 0.2764), shows that the mediating effect of career commitment significantly, and the mediating effect of size 0.1809. At the same time, in the control of intermediary variable career commitment, burnout variables still had significant effects on turnover intention (p < 0.001, LOCI = 0.3465, ULC = 0.5574), showed that career commitment partially mediated the relationship of burnout and turnover intention, so that hypothesis 2b support.
The model 5 shows that the career commitment has a positive effect on job performance (beta = 0.15, p < 0.05), when the career commitment and innovation orientation into the regression equation, career commitment has a positive impact on job performance (beta = 0.15, p < 0.05) (model 7), the center of the career commitment and innovation oriented interaction with the regression equation, the interaction coefficient is not significant (model 8), therefore, hypothesis 3a is not supported. For the regulation of test of innovation oriented career commitment and turnover intention between, this study will career commitment and innovation center of the interaction term into the regression equation (model 14), the results showed significant interaction coefficient (beta = 0.13, p < 0.05), therefore, assume that 3b support (Figure 1).
On the base of theoretical review, this study explored the intermediate mechanism of burnout affecting job performance and turnover intention, and tested the relevant hypotheses through empirical analysis. The higher the burnout, the lower the job performance, while the reverse is the opposite.
This study extends the applicable population and expands the theoretical scope. Previous studies found burnout negatively affecting career commitment.
This study extends the conclusion that career commitment plays an intermediary role in the effect of burnout and turnover intention, burnout influences turnover intention by reducing employee's career commitment. Further analysis revealed that innovation orientation played a negative moderating role in the relationship between career commitment and turnover intention.
The higher the innovation orientation is, the weaker the negative correlation between career commitment and turnover intention is. On the contrary, the negative correlation between job commitment and turnover intention is stronger among the workers with lower innovation orientation.
These findings enrich the role of intermediate variables between burnout and job performance and turnover intention. At the same time, found that the data does not support the hypothesis that H2a and H3a, namely the career commitment plays an intermediary role is not established in the burnout influence on work performance, regulation of innovation orientation between career commitment and job performance is not established.
In fact, in the high pressure competition, individuals feel listless and produce negative mental and physiological reaction, which is direct, which leads to lower work performance directly. In the face of the transformation and upgrading of China’s manufacturing industry, it is necessary to pay attention to the problem of job burnout among skilled workers.
In addition, to help workers strengthen their career planning, but also to meet the reality of enterprise development, the demand for talents, for long-term development of enterprises to provide a strong support and protection of talent. Finally, because of its innovative work values of workers, career commitment negative effect on turnover intention is weaker, the human resources department in addition to the innovative values in the recruitment of workers, but also through a variety of measures to create innovative work values, such as the strengthening of staff training, carry out competition activities and lectures, set up to improve the group, let it continue to learn knowledge, thus strengthening the cultivation of innovative consciousness or workers.
Therefore, workers who are innovative and value oriented will choose to continue to work and study in the enterprise, thus reducing turnover intention. The future research on job burnout and performance and turnover intention can be considered from the following aspects.
Finally, this study adopted a cross-sectional study design, in the strict sense, this only shows that the relationship between variables, cannot fully explain the causal relationship between job burnout and job performance and turnover intention, so future research can use longitudinal research methods to explore the test method such as the causal relationship between variables, improve the Study on persuasion force.