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The European Journal of Public Health Advance Access published online on February 21, 2008
The European Journal of Public Health, doi:10.1093/eurpub/ckn009
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© The Author 2008. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

The same factors influence job turnover and long spells of sick leave—a 3-year follow-up of Swedish nurses

Malin Josephson1, Per Lindberg2, Margaretha Voss2, Lars Alfredsson3,4 and Eva Vingård1

1 Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden
2 Section of Personal Injury Prevention, Karolinska Institutet, Stockholm, Sweden
3 Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
4 Stockholm Center of Public Health, Karolinska University Hospital, Stockholm, Sweden

Correspondence: Malin Josephson, Occupational and Environmental Medicine, Uppsala University, Akademiska sjukhuset, 751 85 Uppsala, Sweden, tel: +46 186113888, e-mail: Malin.Josephson{at}medsci.uu.se

Received July 2, 2007 , accepted January 23, 2008

Background: In many countries, a general shortage of nurses is a public health problem, and retention of nurses in active work is a challenge. The aim of this study was to ascertain whether the same individual factors, working conditions and health problems had led to increased probability of both leaving jobs and prolonged sickness absence in a cohort of Swedish nurses over a period of 3 years. Methods: A baseline questionnaire was answered by 2293 nurses, representing a response rate of 86%. Exposed and unexposed nurses were compared with regard to two outcomes. During the 3-year follow-up, exposed and unexposed nurses were compared with regard to two outcomes: resigning and having at least one sick leave spell that lasted 28 days or longer. Results: We found that 18% of the nurses left their employment, and 16% had sick leave spells ≥28 days. Work in geriatric care, being socially excluded by superiors and/or workmates, negative effects of organizational changes and poor self-rated general health were factors that increased the likelihood of both leaving jobs and long-term sick leave. Conclusions: The present results underline the importance of improving working conditions and supporting sustainable health in order to prevent high turnover and prolonged sick leave among nurses. Resigning and moving to another institution can be interpreted as a way to actively cope with an unhealthy work environment.

Keywords: job turnover, nurses, resignations, sick leave, working conditions


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