Nurse's Foci of Commitment Model to Decrease Turnover Intention

Nursalam Nursalam, Nurul Hikmatul Qowi, Tri Johan Agus Yuswanto, Ferry Efendi


The hospital is an organization in the service sector with nurses as the main hospital resource. Increasing the commitment of the nurses was one of the ways used to retain nurses. This study explained nurse’s foci of commitment model to decrease turnover intention.This study used a cross-sectional approach. Variables in this study included nurse characteristics, job characteristics, work experience, organizational factors, nurse commitment, and turnover intention. The population was nurses who have worked in Islamic hospital in Surabaya, Indonesia. The 119 nurses taken as sample based on simple random sampling. Data collected using questionnaires and analyzed using partial least squares (PLS). Nurse characteristics influenced nurse commitments (path coefficient=0.252; t=2.953) and turnover intention (path coefficient= -0.239; t=2.458). Job characteristics influenced nurse commitments (path coefficient=0.190; t=2.409) and turnover intention  (path coefficient= -0.183; t=2.107). Work experience influenced nurse commitments (path coefficient=0.208; t=2.231) and turnover intention (path coefficient= -0.153; t=1.964). organizational factors influenced nurse commitments (path coefficient=0.218; t=2.170) and turnover intention  (path coefficient= -0.174; t=2.330). Nurse commitment influenced turnover intention (path coefficient= -0.226; t=2.084). The nurse's commitment as moderate these factors in reducing turnover intention. The influence of job satisfaction, nurse commitment, and perceived  organizational support to turnover intention needs further research


G. Basit and S. Duygulu, “Nurses’ organizational trust and intention to continue working at hospitals in Turkey,” Collegian, 2016, doi: 10.1016/j.colegn.2017.05.003.

K. E. Lee, J. H. Kim, and M. J. Kim, “Influence of perceived organizational justice on empowerment, organizational commitment and turnover intention in the hospital nurses,” Indian J. Sci. Technol., vol. 9, no. 20, pp. 1–8, 2016, doi: 10.17485/ijst/2016/v9i20/94702.

C. M. Ulrich et al., “Everyday ethics: Ethical issues and stress in nursing practice,” J. Adv. Nurs., vol. 66, no. 11, pp. 2510–2519, 2010, doi: 10.1111/j.1365-2648.2010.05425.x.

S. De Gieter, J. Hofmans, and R. Pepermans, “Revisiting the impact of job satisfaction and organizational commitment on nurse turnover intention: An individual differences analysis,” Int. J. Nurs. Stud., vol. 48, no. 12, pp. 1562–1569, 2011, doi: 10.1016/j.ijnurstu.2011.06.007.

L. J. Hayes et al., “Nurse turnover: A literature review - An update,” Int. J. Nurs. Stud., vol. 49, no. 7, pp. 887–905, 2012, doi: 10.1016/j.ijnurstu.2011.10.001.

M. Takase, “A concept analysis of turnover intention: Implications for nursing management,” Collegian, vol. 17, no. 1, pp. 3–12, 2010, doi: 10.1016/j.colegn.2009.05.001.

Y. M. Chiang and Y. Chang, “Stress, depression, and intention to leave among nurses in different medical units: Implications for healthcare management/nursing practice,” Health Policy (New. York)., vol. 108, no. 2–3, pp. 149–157, 2012, doi: 10.1016/j.healthpol.2012.08.027.

J. Liu, J. Yang, Y. Liu, Y. Yang, and H. Zhang, “The use of Career Growth Scale in Chinese nurses: Validity and reliability,” Int. J. Nurs. Sci., vol. 2, no. 1, pp. 80–85, 2015, doi: 10.1016/j.ijnss.2015.01.010.

F. North, N and Hughes, “Methodological Challenges to Researching Nursing Turnover in New Zealand: A Progress Report of a National Study,” Asia Pacific J. Heal. Manag., vol. 1, no. 1, pp. 45–51, 2006, [Online]. Available:;dn=628733330779463;res=IELHEA.

C. B. Jones, “Revisiting Nurse Turnover Costs,” JONA J. Nurs. Adm., vol. 38, no. 1, pp. 11–18, 2008, doi: 10.1097/01.NNA.0000295636.03216.6f.

B. C. Holtom, T. R. Mitchell, T. W. Lee, and M. B. Eberly, “5 Turnover and Retention Research: A Glance at the Past, a Closer Review of the Present, and a Venture into the Future,” Acad. Manag. Ann., vol. 2, no. 1, pp. 231–274, 2008, doi: 10.1080/19416520802211552.

R. M. Steers, “Antecedents and Outcomes of Organizational Commitment Author ( s ): Richard M . Steers Source : Administrative Science Quarterly , Vol . 22 , No . 1 ( Mar ., 1977 ), pp . 46-56 Published by : Sage Publications , Inc . on behalf of the Johnson Graduate Sch,” Adm. Sci. Q., vol. 22, no. 1, pp. 46–56, 1977.

S. Su, K. Baird, and B. Blair, “Employee organizational commitment: The influence of cultural and organizational factors in the Australian manufacturing industry,” Int. J. Hum. Resour. Manag., vol. 20, no. 12, pp. 2494–2516, 2009, doi: 10.1080/09585190903363813.

F. Khan and S. Zafar, “the Influence of Organizational Factors on Employees ’ Commitment Levels : a Study of the Banking,” Pakistan Bus. Rev., pp. 570–590, 2014.

J. P. Meyer, A. J. S. Morin, and C. Vandenberghe, “Dual commitment to organization and supervisor: A person-centered approach,” J. Vocat. Behav., vol. 88, pp. 56–72, 2015, doi: 10.1016/j.jvb.2015.02.001.

M. Clugston, “Multiple Bases and Foci of Commitment ?,” J. Manage., vol. 26, no. 1, pp. 5–30, 2000, doi: 10.1177/014920630002600106.

P. Dasgupta, “Examining the Relationship between Turnover Intention of Nurses with Job Satisfaction, Affective, Occupational, and Group Commitments: Study in Private Hospitals,” Jindal J. Bus. Res., pp. 1–10, 2016, doi: 10.1177/2278682115627228.

S. A. Veurink and R. Fischer, “A Refocus on Foci : A Multidimensional and Multi-foci Examination of Commitment in Work Contexts,” vol. 40, no. 3, pp. 160–167, 2011.

S. A. Wasti and Ö. Can, “Affective and normative commitment to organization , supervisor , and coworkers : Do collectivist values matter ?,” J. Vocat. Behav., vol. 73, no. 3, pp. 404–413, 2008, doi: 10.1016/j.jvb.2008.08.003.

D. Knippenberg and E. C. M. Schie, “Foci and correlates of organizational identification,” J. Occup. Organ. Psychol., vol. 73, no. 2, pp. 137–147, 2000, doi: 10.1348/096317900166949.

C. Vandenberghe, K. Bentein, and F. Stinglhamber, “Affective commitment to the organization , supervisor , and work group : Antecedents and outcomes,” vol. 64, pp. 47–71, 2004, doi: 10.1016/S0001-8791(03)00029-0.

D. N. Steers, R. M., & Braunstein, “A Behaviorally-Based Measure of Manifest Needs in Work Settings,” J. Vocat. Behav. 9, pp. 251–266, 1976.

M. T. Guise, “Test of Hackman and Oldham’s job characteristics model in a post-secondary educational setting,” p. 170, 1988.

J. R. Hackman and E. E. Lawler, “Employee reactions to job characteristics.,” J. Appl. Psychol., vol. 55, no. 3, pp. 259–286, 1971, doi: 10.1037/h0031152.

P. GrayToft and J. G. Anderson, “The Nursing Stress Scale: Development of an instrument,” J. Behav. Assess., vol. 3, no. 1, pp. 11–23, 1981, doi: 10.1007/BF01321348.

E. T. Lake, “Development of the practice environment scale of the nursing work index,” Res. Nurs. Heal., vol. 25, no. 3, pp. 176–188, 2002, doi: 10.1002/nur.10032.

Q. Weng and Y. Xi, “The Research of interprise staff careergriwth: validity test and developing a scale,” Manag Rev., vol. 23, no. 10, pp. 132–143, 2011.

Nursalam, Manajemen Keperawatan : Aplikasi dalam Praktik. Keperawatan Profesional. (Edisi Pertama), Salemba Me. Jakarta, 2002.

J. P. Meyer and N. J. Allen, “TCM Employee Commitment Survey Academic Users Guide 2004,” vol. Department, p. 16, 2004, [Online]. Available:

T. E. Becker, “Foci and Bases of Commitment: Are They Distinctions Worth Making?,” Acad. Manag. J., vol. 35, no. 1, pp. 232–244, 1992, doi: 10.2307/256481.

F. Stinglhamber, K. Bentein, and C. Vandenberghe, “Extension of the three-component model of commitment to five foci: Development of measures and substantive test,” Eur. J. Psychol. Assess., vol. 18, no. 2, pp. 123–138, 2002, doi: 10.1027//1015-5759.18.2.123.

T. Perreira, W. Berta, and M. Hebert, “The Employee Retention Triad in Healthcare: Exploring Relationships among Organizational Justice, Affective Commitment and Turnover Intention,” J. Clin. Nurs., vol. 27, no. 1, pp. 1451–1461, Apr. 2018, doi: 10.1111/jocn.14263.

M. Riketta and R. Van Dick, “Foci of attachment in organizations: A meta-analytic comparison of the strength and correlates of workgroup versus organizational identification and commitment,” J. Vocat. Behav., vol. 67, no. 3, pp. 490–510, 2005, doi: 10.1016/j.jvb.2004.06.001.

T. L.-P. Tang, P. H. Cunningham, E. Frauman, M. I. Ivy, and T. L. Perry, “Attitudes and occupational commitment among public personnel: Differences between baby boomers and gen-Xers.,” Public Pers. Manage., vol. 41, no. 2, pp. 327–360, 2012, doi: Retrieved from

B. P. H. Cunningham, T. L. Tang, E. Frauman, M. I. Ivy, and T. L. Perry, “Leisure Ethic , Money Ethic , and Occupationai Commftment Among Recreation and Park Professionais : Does Gender Mai ( e a Difference ?,” Public Pers. Manage., vol. 41, no. 3, pp. 421–449, 2012, doi: 10.1177/009102601204100303.

S. Guerrero, D. Chênevert, and S. Kilroy, “New Graduate Nurses’ Professional Commitment: Antecedents and Outcomes,” J. Nurs. Scholarsh., vol. 49, no. 5, pp. 572–579, 2017, doi: 10.1111/jnu.12323.

J. Fertig, “Evaluating that piece of paper: The effect of motivation and certif ication status on occupational commitment and job competence,” J. Leadersh. Organ. Stud., vol. 18, no. 1, pp. 118–126, 2011, doi: 10.1177/1548051810369342.

Q. Weng and J. C. McElroy, “Corrigendum to ???Organizational career growth, affective occupational commitment and turnover intentions??? [Journal of Vocational Behavior 80/2 (2012) 256???265](S0001879112000164)(10.1016/j.jvb.2012.01.014),” J. Vocat. Behav., vol. 98, no. 2, p. 188, 2012, doi: 10.1016/j.jvb.2016.09.005.

A. Emuwa, “Authentic Leadership : Commitment to Supervisor , Follower Empowerment , and Procedural Justice Climate,” Emerg. Leadersh. Journeys, vol. 6, no. 1, pp. 45–65, 2013.

B. S. Cheng, D. Y. Jiang, and J. H. Riley, “Organizational commitment, supervisory commitment, and employee outcomes in the Chinese context: Proximal hypothesis or global hypothesis?,” J. Organ. Behav., vol. 24, no. 3, pp. 313–334, 2003, doi: 10.1002/job.190.

J. P. Meyer and N. J. Allen, “A Three-Component Model Conceptualization of Organizational Commitment,” Hum. Resour. Manag. Rev., vol. 1, no. 1, pp. 61–89, 1991, doi: 10.1016/1053-4822(91)90011-Z.

J. Zhou et al., “Serial multiple mediation of organizational commitment and job burnout in the relationship between psychological capital and anxiety in Chinese female nurses: A cross-sectional questionnaire survey,” Int. J. Nurs. Stud., vol. 83, pp. 75–82, 2018, doi: 10.1016/j.ijnurstu.2018.03.016.

Halimsetiono, “Peningkatan Komitmen Organisasi untuk Menurunkan Angka Turnover Karyawan Improvement of Organizational Commitment to Lower Employee Turnover,” J. Kesehat. Masy. Nas. Vol., vol. 8, pp. 339–345, 2014.



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