Impact of the effort-reward imbalance model on intent to leave among Belgian health care workers: A prospective study

The aim of this study was to analyse the impact of the effort-reward imbalance (ERI) model on intent to leave the current organization (ITL organization) and intent to leave the nursing profession (ITL profession) in a prospective way. A total of 1,531 health care workers who remained in their job filled in a self-administered questionnaire at baseline and 1 year later. ERI was measured at baseline by a 23-item questionnaire. Multivariate logistic regression analyses were performed. Within a population with low intent to leave at baseline, we found that an imbalance between high efforts and low rewards (extrinsic hypothesis) increased the risk of high ITL organization (OR 4.98; 95% CI 2.07-11.97) and high ITL profession (OR 1.84; 95% CI 1.03-3.30), 1 year later. A high level of overcommitment (OC; intrinsic hypothesis) was not predictive for both intent to leave outcome variables, neither was the interaction between high efforts/low rewards and a high level of OC (interaction hypothesis). Our results showed that a perceived effort-reward imbalance (ERI) at work is a significant predictor of intent to leave among health care workers. This contribution concludes with some directions aimed at boosting nurses' retention and recommendations for future research.