The Importance of Mental Health to the Experience of Job Strain: An Evidence-Guided Approach to Improve Retention

J Nurs Manag. 2009 Apr;17(3):340-51. doi: 10.1111/j.1365-2834.2008.00852.x.


Aims: The purpose of this study was to evaluate the causal relationships between job strain, the practice environment and the use of coping skills in order to assist in the prediction of nurses who are at risk for voluntary turnover and identify potential intervention strategies.

Background: Analysis of the US nurse workforce indicates that it will be necessary to identify new strategies that will promote a healthy workforce and retain nurses in the workplace.

Methods: Exploratory cross-sectional survey of 1235 staff nurses resulted in 308 usable surveys (25%). Data were analysed using multivariate statistical techniques (SEM).

Results: It was determined that diminished mental health status as a component of job strain was predictive of propensity to leave as was a diminished assessment of the professional practice environment. Mental health was favourably influenced by coping behaviour.

Conclusions: Evidence-based strategies which support mental health and reinforce the positive role of coping as a mediating factor may aid in nurse retention efforts.

Implications for nursing management: This study expands the literature by offering a theoretically supported model to evaluate the response of individuals to the experience of job strain in the work environment. The model demonstrated that the health consequences of job strain are modified through the use of active coping behaviour, and that those nurses with elevated self-assessed health had a lower propensity to leave. As active coping may be taught, the model suggests a means to identify those at risk and support manager intervention.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological*
  • Adult
  • Cross-Sectional Studies
  • Evidence-Based Medicine*
  • Female
  • Health Surveys
  • Humans
  • Job Satisfaction*
  • Male
  • Mental Health*
  • Middle Aged
  • Multivariate Analysis
  • Nurses / psychology
  • Personnel Turnover*
  • Professional Practice
  • Propensity Score
  • Stress, Psychological / psychology*
  • United States
  • Workplace / psychology