Age-dependent relationships between work ability, thinking of quitting the job, and actual leaving among Italian nurses: a longitudinal study

Background: Qualified nurses commonly report several work-related problems, which may threat their health and work ability, and may have an impact upon retention. Objective: The aim of the present study was to investigate whether perceived work ability is a predictor for different types of thinking of quitting and for actual exit from the workplace. Design: A prospective study has been performed based on 3329 Italian registered nurses which responded to both measurements of the Nurses' Early Exit Study. Institutions were selected by means of a stratified sampling procedure. All the 7447 nurses working in that healthcare organizations were recruited for the study. Baseline questionnaire was collected from 5504 nurses. Response rate at follow-up was 63.4%. Two hundred and fifty-five nurses left the job in the course of the investigation. Methods: Several multiple logistic regression analyses were performed controlling for indicators of work-related well-being, socio-demographic, and labour-market characteristics. Results: As a whole, our results show that among nurses younger than 45 years work ability is a significant predictor of different types of thinking of quitting, but not of actual exit from the workplace: a lower perceived work ability was associated with a higher desire to undertake further education (OR: 3.05; 95% CI: 1.30-7.18) and/or to change workplace (OR: 4.03; 95% CI: 1.84-8.83) or profession (OR: 6.67; 95% CI: 2.78-15.99). In contrast, among the older nurses (>45), only actual exit was predicted by lower work ability scores (OR: 7.14; 95% CI: 1.15-44.13), along with the perception of a larger availability of free nursing posts in the region (OR: 2.70; 95% CI: 1.13-6.43). Conclusion: Therefore, we conclude that in the relationship between low perceived work ability and intended or actual exit, a significant part is explained by age itself, but also by the age-related differences in occupational and life opportunities. This contribution concludes with some age-related policies aimed at boosting nurses' retention.