DEVELOPINGACONCEPTUALFRAMEWORKFORSTAFF DEVELOPMENTINMALAYSIANURSINGHOME
1M. Shafhuan B. Yusran, 1HasifRafideeB. Hasbollah,1M.FirdausB. M. Nasir
1FacultyofEntrepreneurship and Business, UniversitiMalaysiaKelantan, Malaysia
Email:,,
Abstract-Nursing staffthathadbeenassigneddutiesfor the residents including providepersonalcare, assisting withactivities andmedications,serving meals,andcompleting resident’s laundry and housekeeping.Sometimes,toomanyresponsibilitiesbytakingcareofresidentsmayleadtoworking extrahours. Due to this,nursing staff willexperience frequentchanges in their working shifts, resulting intoextendedovertimeandworkingatdaysoffthatmayresultintoturnover.Turnovermayleadinto potentialnegativehealth outcomefornursing homeresidents innursing staffpayment(salary,wagesand otherbeneficiation)aredisproportionatecomparetotheirworking hours.Itisbecauseofnursing home nursesare the lowestpaid employees in healthcarelabour force. Understandingturnover in nursinghomes areimportantbecauseitcaninfluencetheoperationofanursinghome. Thepurposeofthis paperisto identify thecharacteristics thatcontributetothestaffturnoverby developing aconceptual framework for staff development in retaining the staffin anursing home.Fourcharacteristics thathavebeen identified which arepeople, program, processand rewards.
Keywords:StaffTurnover,StaffDevelopment, NursingHome, StaffRetaining, Malaysia
1. Introduction
Inthiseraofglobalization,every organizationiseagertomanagetheirstaffturnover methodically.Good payand benefits inan economic areverydifficult to an organization in order tomeetthebasic necessitiesofoffering asafeenvironment(Raj,2013). Staffturnoverisacause ofconcernforhealthcareorganizationsthatmayleadtoimplicationonthequality ofservicethat provide tothepatient.Highproductivity,fewer turnoverandbeprofitable were every organizationwishes(Raj,2013).According toRoslan,Hazila,Filzatunand Azahadi,(2014)staff turnover canbereferasthe processthatemployeesleavinganorganizationandneedtobe replaced.Highstaffturnovermay resultinincreasingcostinselectionandrecruitment. Furthermore,turnoverisa largeandexpensive probleminthe long-termcareenvironment (Zhang,Punnett,GoreCPH-NEW,2014)thatmayaffectingqualityofcare,patientsafety and patientsatisfaction(Sellgren,EkvallandTomson,2007).Roslanetal.(2014) addedthatitalso affectstheorganizationalproductivityaswellasthemoraleandmotivationoftheremaining staff.
Innursinghomepointofview,turnoverisathighratebetweennurses,topmanagement,and nurseassistants.Comparing tootheroccupationalgroups,nursestendtoleavetheprofessionata
muchgreater rate(Banaszak-Holl& Hines,1996;Castle,2005;Castle,Engberg,& Men,2007; Castle,2009;Heijden,Dam,Hasselhorn,2009;Hunt,CorazziniandAnderson,2014).Getting alowestpaidemployeesinhealthcareindustry arethemainproblemoftheseturnover (Nolkier, Ejaz,MenneJones,2006).Potentialforgetting negativehealthoutcomeforresidentsmay occur if nursing home got nurse turnover (Castle, Engberg and Men, 2007). As a result, increasingnumberindeficienciescaused by thecharacteristicsoftheresidentwillmakethe remainingnursing stafftoworkingextrahours(Harrington,Zimmerman,Karon,RobinsonBeutel, 2000)and makethepayment becomedisproportionate compareto theirworkinghours.
Moreover,North, Rasmussen,Hughes,Finlayson,Ashton, CampbellandTomkins,(2005) stated thatnursing professionwillbeexperiencing declinenumbersofnewnurses,andolderaverage age ofnewgraduatesandhighratesofyounger nursesleavingtheprofessionduetoan unwillingnesstoaccepttherelatively highstress,lowsalary,andlimitedopportunitiesfor advancement.Thispaper attemptstodevelopaconceptualframeworkfor staff performance developmentinnursinghome Malaysia.The dimensionof the staff developmentsuchaspeople, program, process and rewards will be explored.
MinistryofHealth(2009)statedthatMalaysiahadapproximately75,000activenursesinthe governmentandprivatehospitals.75% of themworkinginthegovernmenthospitalswhile 25% oftheminprivatehospitals.Unfortunately,thenumberisstillnot enoughandMalaysiahospitals have beenforcedtohireforeignnursestomeetthe currentdemand.Asaresult,the situationare gettingworsenwhenmany trainednursesingovernmenthospitalswillingtogototheprivate sectorduetobetteroffersandotherfactorssuchasworking environmentandworkload(Omar, Majid, JohariAnuar, 2014).
1.1 ProblemStatement
In healthcareorganizations,nursing homerespectively,turnovercanbeacauseofconcernasit willgavenegativeoutcomesonthequalityofserviceprovidedtopatient. Failureinretaining nursesinnursinghomemay leadintopotentialnegativehealthoutcomeforresident(Castle, EngbergandMen,2007).Furthermore,increasingindeficienciesmayoccurcausedby the characteristicsoftheresidentthatmaking nursing stafftoworking extrahours(Harrington, Zimmerman,Karon,RobinsonandBeutel,2000).Asa result,itcanhappenwhennursing staff payment(salary,wagesandother beneficiation)are disproportionate compare totheir working hours.Understanding turnoverinnursing homesareimportantbecauseitcaninfluencenursing homefacility operationcost,lowernursingstaffsatisfaction(Parsons,2003),andwillresulting negativeoutcome for residents (CastleEngberg,2003).
Educationheterogeneity alsocaninfluencesthenursing staffturnover(Castle,2005).Poorpain management that including sleep disorder, poor nutrition, depression and stress, anxiety, agitation, decreasedactivity,delayed recuperation,andlowerquality oflifecanaffectthe performanceofthenurses(Ferell,1995;Stein,2001;Herr,2002).Nursing staffmustbe conversantaboutpainandtheirmedicationtodispelresidentandfamily myth(Jones,Fink, Pepper,Hutt,Vojir,Scott,ClarkMellis,2004).Itisbecauseconflictwithresidentsandtheir familiesweresignificantly associatedwithemotionalanddepersonalization(Fujiwara, Tsukishima,Tsutsumi,KawakamiKishi,2003).Trainingisimportanttonursingstaffto
overcomejob-relatedstress.Itisbecausethey required75hoursofentry-leveltraininginorders to train workers properly(Noelkeret. al, 2006).
Top management staffing and profit status also oneofthemost common turnovers (Castle, 2006) becausenursing home’sownermakessomechangesintheir organization(Castle,2006; Donoghue,2010). Satisfactionswithsupervisionare importantbecauseitpositedasa main componentofoveralljobsatisfaction,jobperformanceand retentionofnursing staff(Nolkier, Ejaz,MenneandJones,2006). Lackofsupervisingandcommunicationwithco-workeror supportfromtopmanagementcancreateturnoveramong nursing staff(Fujiwaraetal,2003).In addition,nursinghomefacilitieswithhighersupervisoryworkloadshadlessjobcommitment and can increasedemotionalexhaustion among others colleague(Donoghue, 2010;Mckenzie, Teri,Salazar,Farran,BeckPaun,2011).Supportfromsupervisorisimportanttodecreasing stressamong long-termcarenursing staff (Liang,Hsieh,Lin,andChen,2013). Lackofsupport andassistancefromsupervisorwillmakenursing staffexperiencingnegativephysicaland emotionalchanges(Noelkeret.al,2006).Therefore,toovercomethisproblem,conceptual framework paperwill beproposed.
2. Literature Review
2.1 Dixon StaffDevelopment Model
Staffdevelopmentreferstoasystematically planned,inclusivesetofprofessionallearning opportunitiesthatcarriedoutovertimeforachieving thespecificdistrict-wide,campus,and departmentimprovementobjectives(Dixon,2001).Themaingoalofstaff developmentmodel processisincreasingemployee learningandengagement,andcontinuousimprovementforall staffs byimplementing acultureofprofessional learningbasedcommunitywithin the area.
Staffdevelopmentimprovesthespecialty practiceofnursingprofessionaldevelopmentforthe improvementofhealthcaresignificances(Dixon,2001).Moreover,nursing practicecanbe defined by standards,basedonstudy,andcriticaltoquality patientandorganizationaloutcomes. Dixon(2001)also statedthis modelcancommitinproviding researchandresourcesthatcan enhance the practice locally,ineachorganizationsrespectively.Thismodelalsocanincorporate staffdevelopment in attainingtheorganization’s goals that is can bringpositiveoutcomes.
Figure1:Dixon’sEquity-SensitivePerspectiveModel
Source:AdoptedfromDixon(2001)
Figure1showsthatstaffingmodelsuggestingacloserelationshipbetweenstaffdevelopment andperformanceappraisal.Performanceappraisalinstaffdevelopmentpractiseisdepending on the contextof workplace.The effectivenessofstaff developmentpracticesmustappeartostaff andorganization’simprovementthatoriginatefromdevelopmentalplan,including attentionto both process and recognizematuration in staffhimself.
Dixon(2001) statedthatanEquity-Sensitive Perspective (ESP) modelofleading,educating, and managing hadbeenofferedinstaffing model.ESPmodelis synergistic conversionsmodelthat focusing on people, process andprogram in the context ofinstitutional change. Scott(200)added thattomeetthe needsforexcellence service andprofessional,staffdevelopmentshouldalsobe a priority tostaff.Appropriatestaffdevelopmentprogramsandtrainingwilleventuallyguarantee that continuingeducation process can makethestaff remain knowledgeable.
Themainobjectiveofstaffdevelopmentisimproving thestaffandorganizationaleffectiveness. Thisprocess can affectsthe interpretationsofjobrequirements,relationshipbetweencolleagues andviewpointonthe methodsof working.Ina socialcontext,staff developmentisemphasizing teamwork,builtonafoundationofcollaboration.Furthermore,staffdevelopmentisaprocess thatdemonstrating thecommonnessofpurposeofallstaffandthecriticalnatureofindividual knowledge and skills in orderto perform the assigned duties in relation to theworkgoal.
2.1.1 People
Thismodelisdevelopedforthemanagementoforganizationthatareincreasingly hiringpeople, anddosometaskforotherpeoplewithvariousbackgrounds.Dixon(2001)statedthatpeople shouldbefocusonwaysthatmenandwomen,orvariousraces,reflectdifferencesinvalues, attitudes,behaviourstyles,waysofthinking andculturalbackground.PeopleintheEquity- Sensitive Model that been adopted from Dixon (2001) highlighted ‘people’ that work in
organizationmustfostering awarenessandacceptanceofindividualdifferences,encouragement greaterunderstanding ofthenatureanddynamicsofthedifferences.Inaddition,thismodelhas beenviewashelping participantstounderstandtheirownfeelingsandattitudesaboutvarious people,exploring howthedifferencesmightbetappedasassetsintheworkplaceand attractiveness in work relations between various people.
Dixon(2001)statedthatstaffdevelopmentmustbecognizantofthevariationinthematurityand growthofpeopleandtheorganization.Moreover,atthesametimeassomepeoplemayhave beenservedtheprofessionformanyyearswhileothermay beonly thebeginningoftheir professional careers.Dixon(2001) addedthatthefunctionalrolesof people instaffdevelopment maychangeand need retoolingforthenew responsibilities.
2.1.2 Program
InEquity-Sensitive Model,program isone of the factorswhichisreferredtoanassortmentof termssuchasinservice,continuing professional staffing andassumesvariousforms.Programin staffdevelopmentmodelshouldbeamainconcernofemployeeandorganization.Training and development activities and programs should include all peopleworking within theorganizational division in orderto achievethegoals forqualityserviceand professional and personalgrowth.
Appropriatestaffdevelopmentprogramswillultimately ensuringthatcontinuouseducation occursinorderforstafftostay behindknowledgeableinthefieldofnursinghomemanagement. Moreover,italsoprovidesbasic understandingof the culture inthe organizationaswellas providing abasicunderstanding intheory andpractice(Dixon,2001).Dixon(2001)addedthat using programtopromotestaffdevelopmentinitiativessuchasjobroaster,mentoring,andself- directed trainingcan be an advantages methodforimplementingstaffdevelopment activities.
Furthermore,implementingaprogramcanbevery beneficial by helpingtoaddressissuesof diversity,assistmiscellaneouspopulationswithintegratingmorefully intotheorganizationand by providingstaffingopportunities.Programisanoff-line helpby onepersontoanotherin making significanttransitioninknowledge,workorthinking andalsoconcludethatitisnot usuallyconsideredanofficialaccountability,butarelationshipthatbeendevelopedforpurpose of aidlessexperiencedstaff memberstolearn(Dixon,2001).Dixon(2001) alsostatedthatstaff development program as an initiative that promoting and addressing issues to pertain the diversitythatincludesponsoring training andbasedprogramsuchasworkshopwhichgiveresult to awareness, skill enhancement andcollaborationon various issues.
2.1.3 Process
Dixon(2001)statedthat,allstaffinorganizationwillparticipateinanon-going processofstaff developmenttoachieve the particularmissionofeachdifferent,supervisorswilldevelopa plan forstaffdevelopmentthatencompassthemissionsoftheorganizationandthedepartment.The
aimof ‘process’ instaffdevelopmentmodelisthe effectivenessof improvementinstaff and organizationalandwill affectstheinterpretationofjobrequirements,relationshipbetween colleagues and perspectives on themethods ofworking.
‘Process’of staffdevelopmentoccursinasocialpointof viewandemphasizesteamwork,built onanorganizationof collaboration(Dixon,2001). Staff developmentalsoinclude a processthat willdemonstratesthecommonnessofallstaff’spurposesandthekey natureofindividual knowledgeandskillinordertoperformtheassigneddutiesinrelationtotheorganization’s goals .
Equity-Sensitive Model(ESM) alsopointoutthatthe ‘process’,staff developmentison-going andattachedindaily workandmaking itnoticeableinallpersonnelfunctionofthedivision (Dixon,2001).Inaddition,allofotherstaffing functionsarerelatedto‘process’whichistruein supervisionandperformanceappraisalwhereitisnecessary toestablishandsustainsthe conditionsthatrequiredforeffectivenessofperformance management.If‘process’isproperly facilitated,performanceassessmentwillconfirmsthatemployeecanacceptthe roles,evaluates theextenttowhichperformancegoalsarebeingmet,identify problemsandbarriersinthework environment,providingpositive andbeneficialfeedback,encourageregular jobrelated conversationbetweensupervisorsandstaffmembers,andprovidetheinformationthatneeded fortheperformancereward process.
2.2 Current Model forStaffDevelopmentinNursing Home
Basedon pastliterature,programwithastrong professionaldevelopmentcomponenthavebeen showntoyieldbetterstaffretentionratesandbetterperformanceindevelopmentaltask(Mullei etal,2010).Furthermore,previousresearchandanalyticalliterature by Huntetal,(2014) constantly pointstotherelationshipofhighleveladministrativesupporttothesuccessofstaff developmentinanorganization.Inaddition,leadershipmustbe establishorganizational objectivesthatrelatedtotheimprovementofworking styles,createaclimatethatwillfostering and encouragingstaffdevelopment.
Furthermore,while supportandleadershipofprocessandpeople inorganizationalisimportant, literature also points out the limitation of that leadership. Ha et al (2014) stated that the supervisorshould havethe responsibilityforleadingstaffdevelopment intheorganization, atask thatevidently requiremoretimeandfocusbeforebeingaccepted.Kashetal(2010)statedthata carefulbalanceneedstobe establishedinwhichtheadministrative leadershipsetsthe circumstance forstaffdevelopment.
Well-formedstaffdevelopmentplansrecognizethatmanydiversetrainingareneededovera long period(Dixon,2001).Inaddition,italsorecognizethattraining mustberelatedto organizational mission that should be systematic, demonstrable, and highly regarded improvement ofstaffdevelopment.
2.3 Conceptual FrameworkforStaffDevelopment
Figure2:ConceptualFrameworkfor staffdevelopmentin Malaysianursinghome
Source:AdaptedfromDixonStaffDevelopmentModel
Figure 2indicatesthe conceptualmodelthatbeenadaptedfromDixonstaff developmentmodel. The elementsofpeople,program,andprocesshave beenexplainedinthe literature review. However,there isfourthelementthatcanbe contributedtothe conceptualframeworkwhichis rewards.
2.4 Rewards
Rewardscanbe defineasallthe financial,non-financialandpsychologicalpaymentsthat providedbyorganizationtotheemployeesbecauseoftheircontributionwithinthecompany
(Bratton &Gold, 2003).Furthermore, Malhotra,Budhwar and Prowse (2007) claimed that “work rewards”expressedthebenefits,workerreceivefromthe organization andareconsideredthe “determinantsof job commitmentand satisfaction”. MilkovichandNewman (2004)addedthat thetangiblebenefitsandprovisionsthatbeenobtainby employeewaspartofthe“employment relationship” was representasarewards.Ontheotherhand,financialincentivesare notalways assimilateby employeeandphysicalincentiveusuallynotsatisfiesthebasicpsychologicalneeds (Stone, Bryant and Wier,2010).
Rewarding areessentialasabenefitsandanultimatemotivatortorealizetheorganizational performance(AbbasZaidi, 2011;Ahmadloo,Boroujeni,Gohari,Hosseinipour, 2013).In this globalizationera,rewardinghasbeenadopted bymany differentorganizationswhetherinboth public andprivate sectors.Furthermore,Bowen(2000)andAbbasetal(2011)statedthat rewardingsystemisimportantasamotivatortobuilding upself-esteemandtodeveloppositive relationship between managers and their employees.
Generally,theemployee’sincisivepointofviewtowardstherewarding practicedependsontwo factorswhicharecomplexityandcommunication(Goharietal.,2013).Havingasignificantly communicationof the offer andtheconcentrationonthe rewardsaswellasthe consideration aboutunderstanding themethodologies,targetsand measuresthatapplied whileintroducing rewards aretherequirement foraclearrewardsystems. The firm’sgoal, theirsupplyand theway they were rewarded are crucial for employees to take note because obscurityon this will decrease the motivationvalue (Gibbons,1998).Ivana,LovorkaandNevenka(2009) statedthat rewardingsystemmustbepreciseandclearregarding awards.Moreover,criteriaofsatisfaction andawardrecipient’srecognitionshouldbeattainingby rewards(Ivanaetal,2009).Asaresult, Abbas andZaidi(2011)mention that rewardcanbegivenrelatedto theperformance,appropriate with job measurement and irrevocable.
Goodorganizationsmake a proper rewardmanagementsystemfor their employees;andgood rewardmanagementsystemwhiledecidingrewardsfortheemployeesconsiderbothfinancial andnon-financialrewardsbecauseanidealrewardsystemdoesn’tignoreanyoftheattribute becauseeveryemployeehas different causeofmotivation (Armstrong and Murlis, 1991).
2.5 Monetary andNon-Monetary Rewards
Theoppositionofmonetary andnon-monetaryrewardwasoriginated byHerzberg,Mausnerand Synderman(1957)statedthat the achievement, recognition andadvancement as an non-monetary thatmotivatetheemployeesmorethanmonetaryrewardsuchassalary,jobsecurity orworking environment.Philosophy ofmonetary rewardwasoriginatedfromtheterm“utilitarianism”that employee’sperformancecanbeenhancedby providingmonetary rewards(Zhou,Zhang,Montoro-Sanchez,2009).Furthermore,Zhouetal(2009) addedthatthetermof“romanticism” referstothenon-monetary rewardthatwillboosttheinnovationandcreativenessofthe employees.Bates(2006)indicates,formoney tomotivate,meritpay risesmustbeatleast seven percentsofbasepay foremployeestoperceivethemasmotivatingandtocatchanybody’s intention.
2.5.1 Monetary Rewards
Themostinfluentialandpowerfulincentiveinthesociety ismoney.Moneyalsoisalwaysbeing usedtoinfluenceandmotivateemployeesinanorganization(Zani,Rahim, Junos, Samanol, Ahmad,Merican,SaadAhmad,2011).Llewellyn,EdenandLay (1999)statedthatmonetary rewardswastakeninfromthe formof directfinancialsuchaspersonalincome.Thishasbeen support by MathauerandImhoff(2006),ZaidiandAbbas(2011)andHarunavamweand Kanengoni(2013)statedthat financial incentiveis a form ofmonetaryvalues or equivalents such asbasicsalary,allowancescheme, healthinsurancepremiums,housing allowance,other provisions,increasinginsalaryandbonuses.Adam(2010)hadstatedthatmonetaryrewardisa
‘tangibleawards’.
2.5.2 Non-Monetary Rewards
Non-monetary rewardcanbedefineastheonethatinvolvenodirecttransferoffinancialvalues or equivalent such as holidays, recreational activities and recognition from the superior (MathauerImhoff,2006;HarunavamweKanengoni,2013).Italsocanbedefinedasa status,congeniality ofwork,careerprogressionandhealthcarebenefitsthatofferedtothe employeesinanorganization(Llewellynetal,1999;Moore,M.S.S.W.,2010).Manolopoulos(2008)statedthatnon-monetary rewardsarethefactorssuchas“opportunitiesforcreativity, opportunitytouseinitiativesandtheperceptionofworkimportanceintheoutsideworld”.In addition,non-monetary rewardsaretheonesthatnotinvolvingcashormoney anditisallabout thejobitselfthatmotivatesemployeestowork(Roslizaetal,2011).Non-monetary rewardsare an ‘intangible awards’(Adam, 2010).
3. Conclusion
Thispaperilluminatestheconceptualframeworkfornursinghomestaffdevelopment.Dixon staffdevelopmentmodelthatconsistthe elementofpeople,programandprocesshave been adaptedintothe conceptualframework.However,rewardshadbeenidentifiedasa one of the contributingfactorsofstaffdevelopment.Itisbecauserewardsleveragethesatisfactionofstaff to retain in nursing home. This conceptual paper is the preliminary phase in developing theoretical framework ofstaffdevelopment modelin Malaysia’s nursinghome.
References
Armstrong, M., &Murlis,H., (1991).Reward management. London:Kogan PageLtd.
Banaszak-Holl,J., Hines, M. (1996) Factors associated with nursing home staff turnover. The gerontologist, 36(4), 512-517.
Bowen, B. B., (2000). Recognizingand rewardingemployees, McGraw-Hill
Bratton,J.,Gold,J.,(2003).HumanResourceManagement:TheoryandPractice(3rded.)New
York:PalgraveMacmilian
Castle, N. G., (2005) The effect of top management professional development on administrator turnover. JournalofApplied Gerontologist, 24(5).404-418.
Castle,N.G.,Engberg, J.Men,A.,(2007)Nursing homestaff turnover:Impactonnursing home comparequalitymeasure. Thegerontologist, 47(5),650-661.
Castle,N.G.,(2008)Nursinghomecaregiverstaffinglevelsandqualityofcare.JournalofApplied
Gerontologist, 27(4),375 -405
Castle, N. G., (2008) State differences and facility differences in nursing home staff turnover.
Journalofapplied gerontology, 27(5),609 – 630
Cohen,J.,M.,(1997)Turnoveramongnursinghomestaff:Areview, Nursing Management,28,59
Donoghue, C., (2010) Nursing home staff turnover and retention, Journal of Applied Gerontology,
29(1), 89-106
Ferrell, B. A (1995) Pain evaluation and management in the nursing home, Annals of Internal
Medicine, 123, 681-687
Fujiwara,K.,Tsukishima,E.,Tsutsumi,A.,Kawakami,N.,Kishi,R.,(2003)Interpersonalconflict, Socialsupport, and burnoutamonghomecareworkersinJapan, JournalofOccupational Health,
45, 313-320
Gibbons, R.,(1998). Incentives in organization.JournalofEconomicPerspectives, 12, 115-143
Gohari,P.,Ahmadloo,A.,Boroujeni,M.,B.,Hosseinipour,S.,J.,(2013)Therelationshipbetween
InterdisciplinaryJournalof ContemporaryResearchinBusiness,5(3), 543– 569
Ha, G. J., Kim, J. M., Hwang, Lee, S. G., (2014) Impact of Organizational Characteristics on TurnoverIntentionamongCareWorkersinNursingHomeinKorea:AStructuralEquation Model. Australian HealthReview,38, 425-431
Harrington,C.,Zimmerman,D.,Karon,L.,S.,Robinson, J.,Beutel,P.,(2000)Nursing homeandits relationshipto deficiencies,JournalofGerontology:SocialScience, 55B(5),S278-S287
Harunavamwe,M.,Kanengoni,H.,(2013)TheimpactofMonetary andNon-Monetary RewardsOn motivationamonglowerlevelemployeesandselectedretailshop,AfricanJournalof Business Management,7(38), 3929 -3935
Heijden, B. I.J.M., Dam, K. V., Hasselhorn, H. M., (2009) Intention to leave nursing: The importance of interpersonal work context, work-home interference, and job satisfaction beyondtheeffectofoccupationalcommitment.CareerDevelopmentInternationalVol.14(14),
616 – 635
Herr,K.A.,(2002),Chronicpain:Challengesandassessmentstrategies.JournalofGerontological
Nursing, 28, 20-27
Herzberg,F.,Mausner,B.,Synderman,B.B.,(1959),Themotivationtowork,NewYork:John
Wileyand Sons.
Hunt,S.R.,Corazzini,K.,Anderson,R.A.,(2014)TopNurse-ManagementStaffingCollapseand
CareQualityin NursingHomes. JournalofApplied Gerontology, 33(1) 51-74
Ivana, N., Lovorka, G.,Nevenka, C., (2009). Corporate culture and innovation:Implications of rewardssystems.World AcademyofScience, Engineering andTechnology, 397-402
Jones,K., R., Fink, R., Pepper, G., Hutt, E.,Vojir, C.,P., Scott,J.,Clark, L., &Mellis, F., (2004) Improvingnursinghomestaffknowledgeandattitudesaboutpain,TheGerontologicalSocietyOf
America, 44(4), 469 -478
Kash,B.A.,Naufal,G.S.,Cortes,L.,Johnson,C.E.,(2010).ExploringFactorsAssociated With turnoveramongregisterednurse (RN)supervisor innursing home.JournalofApplied Gerontology, 29(1),107-127
Liang, Y., Hsieh, Y., Lin, Y., Chen, W., (2014). The impact of job stressors on health-related
Health-relatedqualityoflifeofnursingassistantsinlong-termcaresettings.GeriatricNursing,
35, 114-119.
Llewellyn, S., Eden, R.,Lay, C., (1999). Financial and professional incentives in healthcare.
Comparing the UK and Canadian experience. The International Journal of Public Sector
Management,12, 6-16
Malhotra, N., Budhwar, P., Prowse, P., (2007). Linking Rewards to Commitment: an empirical
InvestigationoffourUKcallcentres.InternationalJournalHumanResourceManagement,
18(12), 305-320
Manolopoulos, D.(2008).An evaluation ofemployeemotivation in theextendedpublicsectorin
Greece. EmployeeRelation, 31, 63-85
Mathauer, I., &Imhoff,I., (2006). Health workermotivation inAfrica:The roleofnon-financial incentivesand human resourcemanagement tools. Human ResourceforHealth,1-17
Mckenzie,G.,L.,Teri,L.,Salazar,M.,K.,Farran, C.,J.,Beck,C.,Paun, O.,(2011)Relationship betweensystem-levelcharacteristicsofassistedliving facilitiesandthehealthandsafety of unlicensed staff, AmericanAssociation ofOccupationalHealth Nurses, 59(4), 173– 180
Milkovich, GM., & Newman,JM., (2004). Compensation (8thed.). Burr Ridge, IL:Irwin McGrawHill
Moore, M., M. S. S. W. (2010). Types of employee rewards. employee-rewards.html
Mullei,K.,Mudhune,S.,Wafula,J.,Masamo,E.,Goodman,C.,Lagarde,M.,Blauuw,D.,(2010).
Attractingandretaininghealthworkersinruralareas:investigatingnurses’viewsonruralposts and policyinterventions. BMC Health ServicesResearch, 10(1),1-10
Nazir,T., Shah, S., F., H.,Zaman, K., (2012)Literature reviewontotal rewards: An international
Perspective, AfricanJournalofBusinessManagement, 6(8), 3046– 3058
Noelker,L.,S.,Ejaz,F.,K.,Menne,H.,L.,Jones, J.,A.,(2006)TheimpactofstressandsupportOn nursingassistantsatisfaction withsupervision, JournalofApplied Gerontology,25(4)
307-323
North, N., Rasmussen, E.,Hughes, F., Finlayson, M.,Ashton,T.,Campbell,T.,Tomkins, S.,
(2005)TurnoveramongnursesinNewZealand’sdistricthealthboards:Anationalsurveyof nursingturnover andturnovercost,NewZealandJournalofEmploymentRelations, 30(1), 49
Omar,K.,Majid,A.H.A.,Johari,H.,Anuar,M.M.,(2014)Turnoveropportunity andintentionto leave:Theroleofmoralobligation asamediator, JournalofHuman ResourcesManagement and LaborStudies, 2(3), 1-16
Raj,A.A.A.,(2013)Aqualitativestudy oncausesandeffectsofemployeeturnoverintheprivateSector in Malaysia,Middle-EastJournalofScientificResearch, 16(11), 1532-1541
Robison,J.,Pillemer,K.,(2007)Jobsatisfactionandintentiontoquitamongnursinghomenursing staff:Do specialcareunitsmakeadifference?,JournalofApplied Gerontology
26(1),95 – 112
Roslan,JMG.,Hazilah,N.,AM.,Filzatun,N.,B.,Azahadi,MO.,(2014)Turnoverintentionamong public sectorhealthworkforce:Is job satisfaction the issue? ,TheInternationalMedical JournalMalaysia, 13(1), 51-56
Sellgren, S., Ekvall, G., &Tomson, G., (2007)Nursingstaffturnover:doesleadership matters
Leadershipin HealthService,20(3), 169 – 183
Stein, W.M.,(2001). Pain in nursinghome, ClinicsinGeriatricMedicine,17,515– 594
Stone, DN., Bryant, SM.,Wier, B. (2010).Whyare financial incentiveeffectsunreliable?An extensionofself-determination theory.BehaviourResourceAccount, 22(2),105-132
Zaidi, F., & Abbas, Z., (2011)Astudyon the impactof rewardson employeemotivationin the
TelecommunicationsectorofPakistan,InterdisciplinaryJournalofContemporaryResearchin
Business, 3(3), 978 -998
Zani,R.,M.,Rahim,N.,A.,Junos,S.,Samanol,S., Ahmad,S.,S.,Merican,F.,M.,I.,Saad,M.,S.Ahmad,I.,N.,(2011)Comparing theimpactof financialandnon-financialrewards towards Organizational motivation,Interdisciplinary Journalof Contemporary Research in Business,
3(4),328 -334
Zhang, Y., Punnet, L., Gore, R., Team, CPH-NEW, R., (2014) Relationship among employees’ workingconditions,mentalhealth,andintentiontoleaveinnursinghome,JournalofApplied Gerontology, 33(1),6-23
Zhou,Y.,Zhang,Y.,Montoro-Sanchez,A., (2009).How do rewardapproachesaffect employees’innovativebehaviours?–An empiricalstudy in Chinese.Academic Management, AnnualMeeting Proceedings.P1-6