Professional Documents
Culture Documents
PhD
Dipl.-Psych.
Assistant Professor, Department of Management, Williamson College of Business Adminstration, Youngstown State
University, Youngstown, OH, USA and 2Research Fellow, Department of Psychology, University of Bonn, Bonn,
Germany
Correspondence
Guohong (Helen) Han
Department of Management
Williamson College of Business
Adm.
Youngstown State University
One University Plaza
Youngstown, OH 44555
USA
E-mail: ghan@ysu.edu
Aim The aim of the present study was to investigate whether job satisfaction
mediates between leader-member exchange and nurse turnover intentions.
Background Limited knowledge is available on the mediating role of job satisfaction between leader-member exchange and turnover intentions in the nursing field.
Method This is a cross-sectional survey study. Data were collected in a US hospital.
Results Higher leader-member exchange was associated with lower turnover intentions (b = )0.41, P < 0.001). Leader-member exchange was positively related to ones
job satisfaction (b = 0.50, P < 0.001). Job satisfaction was negatively related to
turnover intentions (b = )0.64, P < 0.001). When leader-member exchange and job
satisfaction were both controlled for, the link between leader-member exchange and
turnover intentions was no longer significant (b = )0.12, P > 0.05).
Conclusion Job satisfaction mediates the link between leader-member exchange and
turnover intentions.
Implications for nursing management The present study reinforces the significant
role of managers. Nurse managers can try to cultivate a good relationship with the
nurses. This can enhance nurses job satisfaction and in turn lower their turnover
intentions.
Keywords: job satisfaction, LMX, turnover intentions
Accepted for publication: 23 August 2010
Introduction
An abundance of studies (e.g. McGowan 2001, Trinkoff et al. 2006) have been devoted to understanding
nursing shortages in terms of what contributes to nurse
turnover, a very costly problem that will continue along
with the substantial global nurse shortage (World
Health Organization 2006). Retention is critical for the
health-care sector, where employees who leave are
DOI: 10.1111/j.1365-2834.2010.01184.x
2010 The Authors. Journal compilation 2010 Blackwell Publishing Ltd
2010 The Authors. Journal compilation 2010 Blackwell Publishing Ltd, Journal of Nursing Management, 19, 4149
turnover intentions as well as actual turnover. Highquality LMX subordinates are, therefore, more likely to
be satisfied with their jobs overall and less likely to
think about quitting.
The negative association between LMX and turnover
intentions has also solicited support from nursing field
research. Laschinger et al. (2009) found that LMX can
predict nurses organizational commitment. Likewise,
Brunetto et al. (2010) found that the supervisorsubordinate relationship was positively associated with
nurses affective commitment. Obviously, this would
indicate low intentions of turnover. Another study (Le
Blanc et al. 1993) found that LMX was negatively related to ones propensity to quit the job.
Therefore, it seems reasonable to predict the negative
relationship between LMX and ones turnover intentions. As we have hypothesized the positive relationship
between LMX and job satisfaction in H1 and the negative relationship between job satisfaction and turnover
intentions in H2, we can now predict that:
H3: Job satisfaction mediates between LMX and
turnover intentions.
Methods
The mediating effect of job satisfaction between
LMX and turnover intentions
High LMX employees tend to have a trust-based relationship with their supervisors (Graen & Uhl-Bien
1995), and consequently they get more resources and
information-based support from their supervisors.
High-quality LMX individuals belong to in-group
members and accordingly enjoy preferential support,
for instance, being assimilated into the leaders personal
network (Sparrow & Liden 2005). So high-quality
LMX individuals are inclined to feel more accepted and
valued. Hence, they are more likely to reap individual
and organizational benefits. Many studies have proved
significant and positive consequences of having a highquality LMX. To illustrate, Sagas and Cunningham
(2004) found that high LMX people reported greater
job and career satisfaction. Wayne et al. (1997) found
that LMX is positively related to perceived organizational support, which contributes to employee satisfaction (Matzler & Renzl 2006) and satisfying
employees socioemotional needs (Cohen & Prusak
2001). LMX has also been found to enhance work
motivation (Lagace et al. 1993) and employees wellbeing at work (Sparr & Sonnentag 2008). In a longitudinal study of 116 new executives, Bauer et al. (2006)
found that LMX is negatively related to new executive
2010 The Authors. Journal compilation 2010 Blackwell Publishing Ltd, Journal of Nursing Management, 19, 4149
43
Measures
This study controlled for the following demographic
differences: age, gender, education and organization
tenure.
Turnover intentions
We used McKay et al.s (2007) scale to measure turnover
intentions. Sample items included I hardly ever think
about leaving; and It would take a lot to get me to leave
the company. Responses to the scale were scored n a sixpoint Likert scale ranging from 1 = strongly disagree to
6 = strongly agree. Intention scores were recoded so that
low scores denote lower intention to leave the firm.
Cronbachs alpha was 0.90 (McKay et al. 2007).
LMX
We used Graen et al. (1982a,b) seven-item LMX measure. Studies have shown that it has sound psychometric
validity (e.g. Graen & Uhl-Bien 1995, Gerstner & Day
1997). This variable was assessed using seven items
based on the member version of LMX questionnaires
developed and used before the research (e.g. Liden &
Graen 1980, Wayne et al. 1997). Cronbachs alpha was
0.93 (Graen et al. 1982a,b). Respondents were asked to
indicate the extent to which the items characterize the
quality of their exchange relationships with their
supervisors, using a seven-point Likert scale ranging
from 1 = strongly disagree to 7 = strongly agree. Items
included My supervisor would be personally inclined to
help me solve problems in my work; My working
relationship with my supervisor is effective; I have
enough confidence in my supervisor that I would defend
and justify his/her decisions if he/she was not present to
do so; My supervisor considers my suggestions for
change; My supervisor and I are suited to each other;
My supervisor understands my problems and needs;
My supervisor recognizes my potential. The answers
were averaged to get the final score for LMX.
Job satisfaction
According to Chen et al. (2004), we asked the participants to indicate their level of satisfaction with the
following aspects of their present job: (1) job content,
(2) supervision, (3) coworker relations, (4) opportunities for promotion, (5) pay and (6) overall satisfaction
44
Analysis
We analysed data using the software package R (R Development Core Team, 2010). R is a free statistical
analysis software and can be downloaded from the
Comprehensive R Archive Network at http://cran.
r-project.org/. To learn more about R , we propose the
free ebook introduction to R by Paradis (2005).
We evaluated descriptive statistics to describe characteristics of our participants. We excluded participants
with missing data on any of the measures (n = 16). We
evaluated Cronbachs alpha as reliability estimates
across all subscales. Statistical analyses included testing
the correlation (Pearsons r) among the various variables and running ordinary multivariate linear regressions. The mediation model was tested using the most
prevalent method (Baron & Kenny 1986) in testing
mediation. To illustrate, Baron and Kenny (1986) argued that a mediation model needs to satisfy the following four steps: (1) there is a significant effect
between the independent variable and the mediator; (2)
there is a significant effect between the mediator and the
dependent variable; (3) there is a significant effect between the independent variable and the dependent
variable; and (4) the significant relationship between the
independent and the dependent variable is reduced
(=partial mediation) or removed (=full mediation) after
controlling for the mediator. In addition to this, we also
conducted the Sobel test based on Preacher and Leonardellis (2001) procedure to confirm the significance
of the mediation model.
Results
Participants
The survey was distributed to about 400 nurses from
seven units of the hospital in three locations. One
2010 The Authors. Journal compilation 2010 Blackwell Publishing Ltd, Journal of Nursing Management, 19, 4149
Table 1
Participants demographics
Gender
Female
Male
Age group (in years)*
2025
2630
3135
3640
4145
4650
5155
5660
>60
Education
High school
Associate degree
Bachelors degree
Masters degree
Continuous variable
Organization tenure (in years)
Descriptive statistics
Categorial variables
164
17
91
9
19
22
27
16
35
29
20
11
2
10
12
15
9
19
16
11
6
1
76
45
57
3
Mean
6.09
42
25
31
2
SD
7.19
Standardized betas
Intercept
Focus variable
LMX
Control variables
Gender
Female
Age group
2630 years
3135 years
3640 years
4145 years
4650 years
5155 years
5660 years
>60 years
Education
Associate degree
Bachelors degree
Masters degree
Organization tenure
Summary statistics
R2
Adjusted R2
F14,166
)0.56
Standard error
0.31
0.50***
0.06
0.28
0.22
0.07
)0.29
0.31
0.11
0.14
0.31
0.74*
0.93
0.27
0.25
0.29
0.25
0.26
0.30
0.33
0.64
0.35*
0.36*
0.01
)0.06
0.16
0.15
0.51
0.07
0.35
0.29
6.26***
*P < 0.05, ***P < 0.001; Gender, age group and education were
dummy coded, i.e., the intercept is the mean of the standardized job
satisfaction for male participants of the age group 2025 years with a
high school degree.
2010 The Authors. Journal compilation 2010 Blackwell Publishing Ltd, Journal of Nursing Management, 19, 4149
45
Table 3
Regression results of job satisfaction on turnover intentions
Variables
Intercept
Independent variables
Job satisfaction
Control variables
Gender
Female
Age group
2630 years
3135 years
3640 years
4145 years
4650 years
5155 years
5660 years
>60 years
Education
Associate degree
Bachelors degree
Masters degree
Organization tenure
Summary statistics
R2
Adjusted R2
F14,166
Standardized betas
Standard error
)0.87**
0.28
)0.64***
0.07
Variables
0.49*
0.20
0.07
0.40
0.29
0.27
0.68**
0.09
0.78*
0.82
0.24
0.23
0.27
0.23
0.24
0.27
0.30
0.59
)0.03
0.34*
)0.14
)0.10
Table 4
Regression results of leader-member exchange (LMX) on turnover
intentions
0.15
0.14
0.46
0.07
0.46
0.41
9.90***
*P < 0.05, **P < 0.01, ***P < 0.001; Gender, age group and education were dummy coded, i.e., the intercept is the mean of the
standardized turnover intentions for male participants of the age
group 2025 years with a high school degree.
Standardized betas
Intercept
Focus variable
LMX
Control variables
Gender
Female
Age group
2630 years
3135 years
3640 years
4145 years
4650 years
5155 years
5660 years
>60 years
Education
Associate degree
Bachelors degree
Masters degree
Organization tenure
Summary statistics
R2
Adjusted R2
F14,166
Standard error
)0.53
0.33
)0.41***
0.07
0.32
0.24
0.12
0.61*
0.10
0.19
0.61*
)0.05
0.30
0.28
0.29
0.27
0.31
0.27
0.28
0.32
0.35
0.68
)0.26
0.11
)0.07
)0.07
0.17
0.17
0.55
0.08
0.25
0.18
3.88***
*P < 0.05, ***P < 0.001; Gender, age group and education were
dummy coded, i.e., the intercept is the mean of the standardized
turnover intentions for male participants of the age group 20
25 years with a high school degree.
Discussion
Theoretical implications
46
2010 The Authors. Journal compilation 2010 Blackwell Publishing Ltd, Journal of Nursing Management, 19, 4149
Table 5
Regression results of leader-member exchange (LMX) on turnover
intentions (controlling for job satisfaction)
Variables
Intercept
Focus variables
LMX
Job satisfaction
Control variables
Gender
Female
Age group
2630 years
3135 years
3640 years
4145 years
4650 years
5155 years
5660 years
>60 years
Education
Associate degree
Bachelors degree
Masters degree
Organization tenure
Summary statistics
R2
Adjusted R2
F14,166
Standardized betas
Standard error
)0.85**
0.28
)0.12
)0.58***
0.07
0.07
0.48*
0.20
0.09
0.44
0.28
0.26
0.70**
0.13
0.73*
0.82
0.24
0.23
0.27
0.23
0.24
0.27
0.30
0.58
)0.06
0.32*
)0.06
)0.10
0.14
0.14
0.46
0.06
0.47
0.42
9.57***
*P < 0.05, **P < 0.01, ***P < 0.001; Gender, age group and education were dummy coded, i.e., the intercept is the mean of the
standardized turnover intentions for male participants of the age
group 2025 years with a high school degree.
Figure 1
Mediating role of job satisfaction between leader-member exchange
and turnover intentions. Displayed is the mediated (upper part) and
unmediated (lower part) linear model.
2010 The Authors. Journal compilation 2010 Blackwell Publishing Ltd, Journal of Nursing Management, 19, 4149
47
Limitations
Notwithstanding, this study has a few limitations that
should be noted. First, this study was a cross-sectional
study, which did not provide us with confidence about
the causality of the model. Longitudinal research is thus
called for in the future to investigate this. Second, the
study was based on self-report survey responses, which
was liable to common method variance bias.
To conclude, we found that high-quality LMX can
lead to greater job satisfaction, which in turn results in
less turnover intentions. We made a great effort to
contribute to the nursing research by examining the
mediating role of job satisfaction between LMX and
turnover intentions. Given the poor economy and budget constraint, fostering a good relationship between a
nurse manager and staff nurses might be a cost-effective
and efficient strategy to cut back on nurse turnover rate.
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