Job preferences of undergraduate nursing students in eastern China: a discrete choice experiment

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Abstract

Background

Shortage and mal-distribution of nursing human resources is an intractable problem in China. There is an urgent need to explore the job preferences of undergraduate nursing students. The main aim of this study is to investigate the stated preferences of nursing students when choosing a job.

Methods

A discrete choice experiment (DCE) was conducted to assess job preferences of the final year undergraduate nursing students from four medical universities/colleges in Shandong Province, China. Job attributes include location, monthly income, bianzhi (which refers to the established posts and can be loosely regarded as state administrative staffing), career development and training opportunity, work environment and working strength. Mixed logit models were used to analyze the DCE data.

Results

A total of 445 undergraduate nursing students were included in the main DCE analysis. They demonstrated higher preference for a job with higher monthly income, and the probability of choosing a rural job would increase to 92.8% if monthly income increased from RMB 2000 (US$ 296) to RMB 8000 (US$ 1183). They expressed higher stated preferences for a job which required light working strength and with excellent work environment over other non-economic attributes. Among all attributes, location was the least important attribute. Subgroup analysis showed that students who came from city or county and whose family income was more than RMB 50 000 (US$ 7396) were significantly willing to pay more monthly income for a job in city.

Conclusions

This study confirmed that economic and non-economic factors both affected the job choices of the students. These results may be more effective for policymakers to perfect the employment policies and design strategies to attract more nursing students taking jobs in rural areas.

Electronic supplementary material

The online version of this article (10.1186/s12960-018-0335-3) contains supplementary material, which is available to authorized users.

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Most cited references 33

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Sample Size Requirements for Discrete-Choice Experiments in Healthcare: a Practical Guide

Esther W. de Bekker-Grob, Bas Donkers, Marcel Jonker … (2015)

Discrete-choice experiments (DCEs) have become a commonly used instrument in health economics and patient-preference analysis, addressing a wide range of policy questions. An important question when setting up a DCE is the size of the sample needed to answer the research question of interest. Although theory exists as to the calculation of sample size requirements for stated choice data, it does not address the issue of minimum sample size requirements in terms of the statistical power of hypothesis tests on the estimated coefficients. The purpose of this paper is threefold: (1) to provide insight into whether and how researchers have dealt with sample size calculations for healthcare-related DCE studies; (2) to introduce and explain the required sample size for parameter estimates in DCEs; and (3) to provide a step-by-step guide for the calculation of the minimum sample size requirements for DCEs in health care. Electronic supplementary material The online version of this article (doi:10.1007/s40271-015-0118-z) contains supplementary material, which is available to authorized users.

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Staffing remote rural areas in middle- and low-income countries: A literature review of attraction and retention

Uta Lehmann, Marjolein Dieleman, Tim Martineau (2008)

Background Many countries in middle- and low-income countries today suffer from severe staff shortages and/or maldistribution of health personnel which has been aggravated more recently by the disintegration of health systems in low-income countries and by the global policy environment. One of the most damaging effects of severely weakened and under-resourced health systems is the difficulty they face in producing, recruiting, and retaining health professionals, particularly in remote areas. Low wages, poor working conditions, lack of supervision, lack of equipment and infrastructure as well as HIV and AIDS, all contribute to the flight of health care personnel from remote areas. In this global context of accelerating inequities health service policy makers and managers are searching for ways to improve the attraction and retention of staff in remote areas. But the development of appropriate strategies first requires an understanding of the factors which influence decisions to accept and/or stay in a remote post, particularly in the context of mid and low income countries (MLICS), and which strategies to improve attraction and retention are therefore likely to be successful. It is the aim of this review article to explore the links between attraction and retention factors and strategies, with a particular focus on the organisational diversity and location of decision-making. Methods This is a narrative literature review which took an iterative approach to finding relevant literature. It focused on English-language material published between 1997 and 2007. The authors conducted Pubmed searches using a range of different search terms relating to attraction and retention of staff in remote areas. Furthermore, a number of relevant journals as well as unpublished literature were systematically searched. While the initial search included articles from high- middle- and low-income countries, the review focuses on middle- and low-income countries. About 600 papers were initially assessed and 55 eventually included in the review. Results The authors argue that, although factors are multi-facetted and complex, strategies are usually not comprehensive and often limited to addressing a single or limited number of factors. They suggest that because of the complex interaction of factors impacting on attraction and retention, there is a strong argument to be made for bundles of interventions which include attention to living environments, working conditions and environments and development opportunities. They further explore the organisational location of decision-making related to retention issues and suggest that because promising strategies often lie beyond the scope of human resource directorates or ministries of health, planning and decision-making to improve retention requires multi-sectoral collaboration within and beyond government. The paper provides a simple framework for bringing the key decision-makers together to identify factors and develop multi-facetted comprehensive strategies. Conclusion There are no set answers to the problem of attraction and retention. It is only through learning about what works in terms of fit between problem analysis and strategy and effective navigation through the politics of implementation that any headway will be made against the almost universal challenge of staffing health service in remote rural areas.

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A critical review of interventions to redress the inequitable distribution of healthcare professionals to rural and remote areas.

Nathan Wilson, Ian D Couper, Elma de Vries … (2015)

The shortage of healthcare professionals in rural communities is a global problem that poses a serious challenge to equitable healthcare delivery. Both developed and developing countries report geographically skewed distributions of healthcare professionals, favouring urban and wealthy areas, despite the fact that people in rural communities experience more health related problems. This review provides a comprehensive overview of the most important studies addressing the recruitment and retention of doctors to rural and remote areas. A comprehensive search of the English literature was conducted using the National Library of Medicine's (PubMed) database and the keywords '(rural OR remote) AND (recruitment OR retention)' on 3 July 2008. In total, 1261 references were identified and screened; all primary studies that reported the outcome of an actual intervention and all relevant review articles were selected. Due to the paucity of prospective primary intervention studies, retrospective observational studies and questionnaire-driven surveys were included as well. The search was extended by scrutinizing the references of selected articles to identify additional studies that may have been missed. In total, 110 articles were included. In order to provide a comprehensive overview in a clear and user-friendly fashion, the available evidence was classified into five intervention categories: Selection, Education, Coercion, Incentives and Support - and the strength of the available evidence was rated as convincing, strong, moderate, weak or absent. The main definitions used to define 'rural and/or remote' in the articles reviewed are summarized, before the evidence in support of each of the five intervention categories is reflected in detail. We argue for the formulation of universal definitions to assist study comparison and future collaborative research. Although coercive strategies address short-term recruitment needs, little evidence supports their long-term positive impact. Current evidence only supports the implementation of well-defined selection and education policies, although incentive and support schemes may have value. There remains an urgent need to evaluate the impact of untested interventions in a scientifically rigorous fashion in order to identify winning strategies for guiding future practice and policy.

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Author and article information

Contributors

Tongtong Liu: liutongtong23@163.com

Shunping Li:

ORCID: http://orcid.org/0000-0001-8144-6220

lishunping@sdu.edu.cn

Renyong Yang: jnyry@mail.jnmc.edu.cn

Shimeng Liu: mototo99@163.com

Gang Chen: gang.chen@flinders.edu.au

Journal

Journal ID (nlm-ta): Hum Resour Health

Journal ID (iso-abbrev): Hum Resour Health

Title: Human Resources for Health

Publisher: BioMed Central (London )

ISSN (Electronic): 1478-4491

Publication date (Electronic): 3 January 2019

Publication date PMC-release: 3 January 2019

Publication date Collection: 2019

Volume: 17

Electronic Location Identifier: 1

Affiliations

[1 ]GRID grid.412521.1, The Affiliated Hospital of Qingdao University, ; Qingdao, 266000 China

[2 ]ISNI 0000 0004 1761 1174, GRID grid.27255.37, School of Health Care Management, , Shandong University, ; Jinan, 250012 China

[3 ]ISNI 0000 0004 1761 1174, GRID grid.27255.37, NHC Key Laboratory of Health Economics and Policy Research (Shandong University), ; Jinan, 250012 China

[4 ]GRID grid.449428.7, Jining Medical University, ; Jining, 272067 China

[5 ]ISNI 0000 0004 0367 2697, GRID grid.1014.4, College of Medicine and Public Health, , Flinders University, ; Adelaide, 5042 Australia

Author information

Shunping Li http://orcid.org/0000-0001-8144-6220

Article

Publisher ID: 335

DOI: 10.1186/s12960-018-0335-3

PMC ID: 6318922

PubMed ID: 30606232

SO-VID: 5ab14948-82f9-4b94-9242-5eb569dd96d6

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 18 July 2018

Date accepted : 3 December 2018

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ScienceOpen disciplines: Health & Social care

Keywords: discrete choice experiments,job preferences,undergraduate nursing students,china

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ScienceOpen disciplines: Health & Social care

Keywords: discrete choice experiments, job preferences, undergraduate nursing students, china

Job preferences of undergraduate nursing students in eastern China: a discrete choice experiment

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China Occupational Medicine

Most cited references 33

Sample Size Requirements for Discrete-Choice Experiments in Healthcare: a Practical Guide

Staffing remote rural areas in middle- and low-income countries: A literature review of attraction and retention

A critical review of interventions to redress the inequitable distribution of healthcare professionals to rural and remote areas.

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