DOI QR코드

DOI QR Code

The Retention Factors among Nurses in Rural and Remote Areas: Lessons from the Community Health Practitioners in South Korea

  • Park, Hyejin (Department of Applied Health Science, Indiana University School of Public Health) ;
  • June, Kyung Ja (Department of Nursing, Soonchunhyang University)
  • Received : 2022.03.26
  • Accepted : 2022.07.18
  • Published : 2022.09.30

Abstract

Purpose: This study analyzed the retention factors of Korean community health practitioners who sustained over 20 years based on a multi-dimensional framework. This study suggests global implications for nurses working in rural or remote areas, even during a worldwide pandemic. Methods: The participants were 16 Korean community health practitioners who worked in rural or remote locations for over 20 years. This study identified nurses' key retention factors contributing to long service in rural and remote areas. This is a qualitative study based on the narrative method and analysis was conducted using grounded theory. A semi-structured questionnaire was conducted based on the following: the life flow of the participants' first experience, episodes during the work experience, and reflections on the past 20 years. Results: First, personal 'financial needs' and 'callings' were motivation-related causal conditions. The adaptation of environment-work-community was the contextual condition leading to intervening conditions, building coping strategies by encountering a lifetime crisis. The consequences of 'transition' and 'maturation' naturally occurred with chronological changes. The unique factors were related to the 'external changes' in the Korean primary health system, which improved the participants' social status and welfare. Conclusion: Considering multi-dimensional retention factors was critical, including chronological (i.e., historical changes) and external factors (i.e., healthcare systems), to be supportive synchronously for rural nurses. Without this, the individuals working in the rural areas could be victimized by insecurity and self-commitment. Furthermore, considering the global pandemic, the retention of nurses is crucial to prevent the severity of isolation in rural and remote areas.

Keywords

Acknowledgement

The authors would like to thank all the Community Health Practitioners who, despite their busy schedules, gave time to participate in this study. We would also like to thank the Community Health Practitioner Association, which helped recruit participants for this study. HP would like to thank Dr. CY Kim, Dr. SH Yoo, and Dr. BH Cho for their guidance during the master's thesis process.

References

  1. Mbemba GIC, Gagnon MP, Hamelin-Brabant L. Factors influencing recruitment and retention of healthcare workers in rural and remote areas in developed and developing countries: An overview. Journal of Public Health in Africa. 2016;7(2):565. https://doi.org/10.4081/jphia.2016.565
  2. Bragg S, Bonner A. Losing the rural nursing workforce: Lessons learnt from resigning nurses. The Australian Journal of Rural Health. 2015;23(6):366-370. https://doi.org/10.1111/ajr.12251
  3. Collado CB. Primary health care. A continuing challenge. Nursing & Health care: Official Publication of the National League for Nursing. 1992;13(8):408-413. https://europepmc.org/article/med/1480333
  4. Jung KI, Yoon SO, Shin HJ, Shin DS. Job satisfaction and related factors among community health practitioners. Journal of Korean Academy of Rural Health Nursing. 2009;4(2):120-127. https://doi.org/10.22715/JKARHN.2009.4.2.120
  5. Kwak C, Ko Y. Historical overview of community health practitioners in Korea. Public Health Nursing. 2015;32(2):161-168. https://doi.org/10.1111/phn.12143
  6. Herzberg F, Mausner B, Snyderman BB. The motivation to work. New Brunswick and London; Transaction Publishers; 2017. 155 p.
  7. Campbell N, McAllister L, Eley DS. The influence of motivation in recruitment and retention of rural and remote allied health professionals: A literature review. Rural and remote health. 2012;12(2):1900. https://doi.org/10.22605/RRH1900
  8. Lehmann U, Dieleman M, Martineau T. Staffing remote rural areas in middle- and low-income countries: a literature review of attraction and retention. BMC Health Services Research. 2008;8:19. https://doi.org/10.1186/1472-6963-8-19
  9. Dolea C, Stormont L, Braichet JM. Evaluated strategies to increase attraction and retention of health workers in remote and rural areas. Bulletin of the World Health Organization. 2010;88(5):379-385. https://doi.org/10.2471/BLT.09.070607
  10. Russell DJ, McGrail MR, Humphreys JS. Determinants of rural Australian primary health care worker retention: a synthesis of key evidence and implications for policymaking. The Australian Journal of Rural Health. 2017;25(1):5-14. https://doi.org/10.1111/ajr.12294
  11. Khalil M, Alameddine M. Recruitment and retention strategies, policies, and their barriers: A narrative review in the Eastern Mediterranean Region. Health Science Reports. 2020;3(4):e192. https://doi.org/10.1002/hsr2.192
  12. Kulig JC, Stewart N, Penz K, Forbes D, Morgan D, Emerson P. Work setting, community attachment, and satisfaction among rural and remote nurses. Public Health Nursing. 2009;26(5):430-439. https://doi.org/10.1111/j.1525-1446.2009.00801.x
  13. Roberge CM. Who stays in rural nursing practice? An international review of the literature on factors influencing rural nurse retention. Online Journal of Rural Nursing and Health Care. 2009;9(1):82-93. https://doi.org/10.14574/ojrnhc.v9i1.107
  14. Sharp DB. Factors related to the recruitment and retention of nurse practitioners in rural areas [dissertation]. [El Paso]: The University of Texas at El Paso; 2010. 48 p.
  15. Im E-O. Theory of Transitions. In: Smith MJ, Liehr PR, editors. Middle range theory for Nursing. 4th ed. New York: Springer Publishing Company; 2018. p. 253-276.
  16. Polkinghorne DE. Narrative and self-concept. Journal of Narrative and Life History. 1991;1(2-3):135-153. https://doi.org/10.1075/jnlh.1.2-3.04nar
  17. Patton MQ. Strategic themes in qualitative inquiry. In: Laughton CD, Peterson K, editors. Qualitative research and evaluation methods. 3rd ed. Thousand Oaks CA: Sage Publications; 2002. p. 37.
  18. Park D. Gejeo Baraman Bolsu Isseodo. Sajinyesulsa; 2013.280 p.
  19. Corbin JM, Strauss A. Grounded theory research: Procedures, canons, and evaluative criteria. Qualitative Sociology. 1990;13:3-21. https://doi.org/10.1007/BF00988593
  20. Strauss A, Corbin J. Basics of qualitative research techniques. 2nd ed. Thousand Oaks CA: Sage Publications; 1998. 311 p.
  21. Charmaz K. Reconstructing grounded theory. The SAGE Handbook of Social Research Methods; 2008. p. 461-478.
  22. Robert Wood Johnson Foundation. Qualitative research guidelines project [Internet]. Princeton: New Jersey; c2006 [cited 2022 June 24]. Available from: http://www.qualres.org/HomeSemi-3629.html
  23. Ishikawa M. Distribution and retention trends of obstetricians and gynecologists in Japan: A longitudinal study. JMA Journal. 2021;4(3):262-269. https://doi.org/10.31662/jmaj.2020-0125
  24. Isaacs AN, Raymond A, Jacob A, Hawkings P. Job satisfaction of rural medical interns: A qualitative study. The Australian Journal of Rural Health. 2020;28(3):245-251. https://doi.org/10.1111/ajr.12633
  25. Mittal V, Rosen J, Leana C. A dual-driver model of retention and turnover in the direct care workforce. The Gerontologist. 2009;49(5):623-634. https://doi.org/10.1093/geront/gnp054
  26. Mbemba G, Gagnon MP, Pare G, Cote J. Interventions for supporting nurse retention in rural and remote areas: An umbrella review. Human Resources for Health. 2013;11(1):44. https://doi.org/10.1186/1478-4491-11-44