1. Health Related Quality of Life: Prevalence and Its Associate on the Intention to Leave Nursing Career. Nittaya Phosrikham

2. Contents BACKGROUND 1 MATERIALS AND METHODS 2 RESULTS 3 DISCUSSIONS 4

3. BACKGROUND  Health Related Quality of Life (HRQOL) is an important health outcome indicator  Previous study : HRQOL of nurses was lower than that in general population Wu et al. 2011==> Nurses in China : HRQOL of nurses was low compared with that in the population of Shanghai He et al. 2012 ==>Doctors and nurses in China : doctors and nurses have relatively poor HRQOL especially in self- reporting pain/discomfort and anxiety/depression compared with inhabitants aged 15–64 years. ***In cortex of the Registered Thai Nurses has not been studied.

4.  HRQOL in nurses is affected by many factors, Not clarified about its effect on another factors, including Intention to Leave (ITL) of nursing career.  Relationship between ITL with many factors such as QWL, burnout, stress and depression but HRQOL has been not clarified and in cortex of the Registered Thai Nurses has not been studied. BACKGROUND

5. To investigate the prevalence of Health Related Quality of Life among registered nurses (RNs) in Thailand Objective To investigate the association of health related quality of life and intention to leave in a nursing career among Registered Thai Nurses in Thailand Research Question and Objective What is the prevalence of HRQOL among registered nurses (RNs) in Thailand ? What is the magnitude of effect of HRQOL on the intention to leave a nursing career? RQ

6.  Study Design - A cross sectional study, part of the first wave survey of Thai nurses cohort study conduct 2010  Study outcome -Primary outcome : Health Related Quality of Life (HRQOL) -Secondary outcome : Intention to Leave (ITL) MATERIALS AND METHODS

7. good, mild, moderate, severe health states - good health -fair or poor health” - good health -fair or poor health” Health Related Quality of Life (HRQOL) was assessed by Euroqol- 5D (Eq-5D Intention to Leave (ITL) a nursing career within 1-2 years or after 2 years - ITL” - No ITL” MATERIALS AND METHODS

8.  Statistical analysis Descriptive : Frequency, percentage Statistics : Mean, Standard deviation, Median, Minimum, Maximum Bivariate Analysis : Crude ORs Multiple Analysis : Adjusted ORs  Statistical analysis Descriptive : Frequency, percentage Statistics : Mean, Standard deviation, Median, Minimum, Maximum Bivariate Analysis : Crude ORs Multiple Analysis : Adjusted ORs STATA version 12.0 Covariate : Gender, Age, Marital status, Highest education attainment, Current major work position, Workplace, Liabilities, Sufficiency of monthly income, Scheduled time, Schedule usually worked in main nursing job, Working experienced and Having musculoskeletal disorders. Covariate : Gender, Age, Marital status, Highest education attainment, Current major work position, Workplace, Liabilities, Sufficiency of monthly income, Scheduled time, Schedule usually worked in main nursing job, Working experienced and Having musculoskeletal disorders.

9. RESULTS Total number of registered nurses (N = 142,698) Sampled and mailed the questionnaires (n = 50,209) Contactable (n= 30,209) Returned questionnaires and enrolled (n= 18,756) Currently in nursing career (n = 16,631) Currently in nursing career (n = 16,316) Aim 1 Aim 2 Excluded (n = 2,125) - Currently not involved in nursing career (n = 1,709) - Missing data on current working status and/or health related quality of life (n = 416) Excluded (n = 2,125) - Currently not involved in nursing career (n = 1,709) - Missing data on current working status and/or health related quality of life (n = 416) Excluded Missing data on intention to leave in nursing career (n = 315) 18,200 could not be contacted due to wrong addresses

10. Demographic Characteristics - Female : 96.8% - Mean age: 43.0  9.4 years old (ranged: 18.6-65.3) - Bachelor’s degree: 57.3% - Practical nurses: 67.4% - Married: 60.8% - Workplace: Hospital (83.0%) - Sufficiency of monthly income: Saving (35.3%) -Schedule time: 8 hr per shift (94.4%) -Schedule usually worked in main nursing job : Regular daytime shift (51.0%) - Mean of Work experience: 20.5.0  9.6 years RESULTS

11. Fair or Poor state Good state 95%CI: 43.1 to 44.6 95%CI: 55.4 to 56.9

12. RESULTS 

13. DISCUSSIONS * The prevalence of Fair or Poor health state among registered nurses was 43.8% (95%CI: 43.1 to 44.6), Thai population, 54.2% * Overall mean HRQOL score HRQOL score of 0.693 (standard deviation = 0.119). - nurses possess more knowledge and skills for disease prevention - nurses access health care service more conveniently than the Thai population (70% of sample lived in rural area) * The prevalence of Fair or Poor health state among registered nurses was 43.8% (95%CI: 43.1 to 44.6), Thai population, 54.2% * Overall mean HRQOL score HRQOL score of 0.693 (standard deviation = 0.119). - nurses possess more knowledge and skills for disease prevention - nurses access health care service more conveniently than the Thai population (70% of sample lived in rural area)

14. DISCUSSIONS * According each dimension : percentage of nurses who having some problem was quite high in pain/ discomfort dimension - 67.4% were currently practical nurses who having job characteristic which use more physical effort * According each dimension : percentage of nurses who having some problem was quite high in pain/ discomfort dimension - 67.4% were currently practical nurses who having job characteristic which use more physical effort * Nurses of the other country found that the previous HRQOL study which was assessed by Euroqol-5D (Eq-5D) can’t be compared

15. * There was association between HRQOL and intention to leave nursing career - not controlled by other factors that there was association (OR = 0.15; 95%CI: 0.11 to 0.21; p-value <0.001 - adjusted for another factors that there were associated (OR = 0.17; 95%CI: 0.10 to 0.18; p-value <0.001) (high protective factors ) * There was association between HRQOL and intention to leave nursing career - not controlled by other factors that there was association (OR = 0.15; 95%CI: 0.11 to 0.21; p-value <0.001 - adjusted for another factors that there were associated (OR = 0.17; 95%CI: 0.10 to 0.18; p-value <0.001) (high protective factors ) DISCUSSIONS * The findings indicate the need to improve the health related quality of life.

16. Strength of the study : a large of sample sizes which could accurately represent the situation of health related quality of life and intention to leave nursing career among Thai registered nurses. Limitation of the study - The questionnaires was created for several research purposes which was not specific in this study. - Self-administration questionnaire could create information and recalled bias. - The cross sectional design cannot indicated the causal factors and could explain only the relationship. Limitation of the study - The questionnaires was created for several research purposes which was not specific in this study. - Self-administration questionnaire could create information and recalled bias. - The cross sectional design cannot indicated the causal factors and could explain only the relationship.

17. CONCLUSION The prevalence of fair or poor health state was 43.8% (95%CI: 43.1 to 44.6) and Overall mean HRQOL score HRQOL score of 0.693 (SD = 0.119). Health related quality of life associate to intention to leave a nursing career : adjusted for another factors that there were associated (OR = 0.17; 95%CI: 0.10 to 0.18; p-value <0.001 The prevalence of fair or poor health state was 43.8% (95%CI: 43.1 to 44.6) and Overall mean HRQOL score HRQOL score of 0.693 (SD = 0.119). Health related quality of life associate to intention to leave a nursing career : adjusted for another factors that there were associated (OR = 0.17; 95%CI: 0.10 to 0.18; p-value <0.001 These finding should encourage nursing administrators and policy makers to deliver focused interventions to reduce nurses’ intention to leave nursing career through improving the health related quality of life dimensions.

18. Recommendations Recommendation for organization: organization should encourage nursing administrators and policy makers to reduce nurses’ intention to leave nursing career. Recommendation for future study: should be conducted to determine causes of health related quality of life and practical intervention program to improve improving the health related quality of life.

19. - Human Resource for Health Research and Development Office, Health System Research Institute, the International Health Planning and Policy, and the Thailand Nursing and Midwifery Council - Prof. Dr. Bandit Thinkamrop - Dr.Cameron Hurst - Miss Wilaiphorn Thinkamrop - Dr. PH Batch 4 - My classmate ACKNOWLEDGEMENTS