Investigating the Mediating Effect of Job Satisfaction on the Link Between Teamwork and Turnover Intentions: A Structural Equation Modelling Approach

Yıl 2025, Cilt: 10 Sayı: 3, 412 - 430

Çağatay Yılmaz

https://doi.org/10.31201/ijhmt.1783253

Öz

Aim: While teamwork in the healthcare context has been widely studied in relation to organizational outcomes, such as performance and patient safety, its impact on employee outcomes, including turnover intention, has received comparatively less attention. To address this research gap, the current study was conducted to examine the mediating role of job satisfaction in the relationship between teamwork perceptions and turnover intentions among healthcare professionals in Türkiye.
Methods: A cross-sectional design with a survey method was used to recruit 238 healthcare professionals working in hospital settings. The “TEAMSTEPPS Teamwork Perceptions Questionnaire,” “Job Diagnostic Survey,” “Turnover Intention Scale,” and “Demographic Question Form” were used as measures. Structural equation modeling (SEM) with 5,000 bootstrap replications was carried out for the analyses.
Results: Findings revealed that teamwork perceptions were positively associated with job satisfaction (β = .489, p<.001). Job satisfaction, in turn, was negatively related to turnover intention (β = –.271, p<.01). A direct negative relationship was also found between teamwork perceptions and turnover intention (β = –.227, p<.01). These results indicate that job satisfaction partially mediates the relationship between teamwork perceptions and turnover intention.
Conclusion: Teamwork plays a significant role in enhancing job satisfaction and reducing turnover intentions among healthcare professionals. Strategic interventions to strengthen team dynamics, particularly in leadership and mutual support, may help foster workforce stability in healthcare organizations.

Anahtar Kelimeler

teamwork , job satisfaction , turnover intention

Etik Beyan

Ethical approval for the research was obtained from the Research Ethics Committee of Abdullah Gül University (Date: 25/08/2020 – Decision Number: 7049).

Destekleyen Kurum

None

Ekip Çalışması ile İşten Ayrılma Niyeti Arasındaki İlişkide İş Tatmininin Aracı Etkisinin İncelenmesi: Bir Yapısal Eşitlik Modellemesi Yaklaşımı

Öz

Amaç: Sağlık bağlamında ekip çalışması, performans ve hasta güvenliği gibi örgütsel çıktılarla ilişkisi açısından biçimde incelenmiştir. Ancak, işten ayrılma niyeti de dahil olmak üzere çalışan çıktıları üzerindeki etkisi görece daha az dikkat çekmiştir. Bu araştırma boşluğunu gidermek amacıyla, mevcut çalışma Türkiye’deki sağlık profesyonelleri arasında ekip çalışması algıları ile işten ayrılma niyeti arasındaki ilişkide iş tatmininin aracılık rolünü incelemek için gerçekleştirilmiştir.
Yöntem: Kesitsel desen kullanılmış ve hastane ortamlarında görev yapan 238 sağlık profesyonelinden anket yöntemiyle veri toplanmıştır. Ölçüm araçları olarak “TEAMSTEPPS Ekip Çalışması Algıları Ölçeği,” “İş Özellikleri Ölçeği,” “İşten Ayrılma Niyeti Ölçeği” ve “Demografik Bilgi Formu” kullanılmıştır. Analizler için 5.000 bootstrap tekrarıyla Yapısal Eşitlik Modellemesi (YEM) uygulanmıştır.
Bulgular: Sonuçlar, ekip çalışması algılarının iş doyumu ile pozitif yönde ilişkili olduğunu göstermiştir (β = .489, p<.001). İş doyumu ise işten ayrılma niyetiyle negatif yönde ilişkili bulunmuştur (β = –.271, p<.01). Ayrıca, ekip çalışması algıları ile işten ayrılma niyeti arasında doğrudan negatif bir ilişki saptanmıştır (β = –.227, p<.01). Bu sonuçlar, iş doyumunun ekip çalışması algıları ile işten ayrılma niyeti arasındaki ilişkide kısmi aracılık rolü üstlendiğini göstermektedir.
Sonuç: Ekip çalışması, sağlık profesyonelleri arasında iş doyumunu artırmada ve işten ayrılma niyetini azaltmada önemli bir rol oynamaktadır. Özellikle liderlik ve karşılıklı destek boyutlarına odaklanan stratejik müdahaleler, sağlık kuruluşlarında işgücü istikrarını güçlendirmeye yardımcı olabilir.

Anahtar Kelimeler

ekip çalışması , iş tatmini , işten ayrılma niyeti

Etik Beyan

Araştırma için etik onay, Abdullah Gül Üniversitesi Araştırma Etik Kurulu’ndan alınmıştır (Tarih: 25/08/2020 – Karar No: 7049).

Kaynakça

• Alam, A., & Asim, M. (2019). Relationship Between Job Satisfaction And Turnover Intention. International Journal of Human Resource Studies, 9(2), 163. https://doi.org/10.5296/ijhrs.v9i2.14618
• Al Sabei, S. D., Labrague, L. J., Al-Rawajfah, O., AbuAlRub, R., Burney, I. A., & Jayapal, S. K. (2022). Relationship between interprofessional teamwork and nurses’ intent to leave work: The mediating role of job satisfaction and burnout. Nursing Forum, 57(4), 568–576. https://doi.org/10.1111/nuf.12706
• Bae, S. H. (2022). Noneconomic and economic impacts of nurse turnover in hospitals: A systematic review. International Nursing Review, 69(3), 392–404. https://doi.org/10.1111/inr.12769
• Bakker, A. B., & Demerouti, E. (2007). The Job Demands‐Resources model: State of the art. Journal of Managerial Psychology, 22(3), 309–328. https://doi.org/10.1108/02683940710733115
• Basım, H. N., & Şeşen, H. (2009). Örgütsel adalet algısı-örgütsel vatandaşlık davranışı ilişkisinde iş tatmininin aracılık rolü. In Proceedings of the 17th Management and Organization Congress. Eskişehir, Turkey.
• Battles, J. K. H., & King, H. B. (2010). TeamSTEPPS Teamwork Perceptions Questionnaire (T-TPQ) manual. American Institutes for Research.
• Bayramlık, H., Bayık, M. E., & Güney, G. (2015). Kişi-Örgüt Uyumunun İş Tatmini Üzerine Etkisi: Ankara İlinde İş Makineleri Sektörü İşgörenleri Üzerinde Bir Uygulama. Kara Harp Okulu Bilim Dergisi, 25(2), Article 2.
• Bernales-Turpo, D., Quispe-Velasquez, R., Flores-Ticona, D., Saintila, J., Ruiz Mamani, P. G., Huancahuire-Vega, S., Morales-García, M., & Morales-García, W. C. (2022). Burnout, Professional Self-Efficacy, and Life Satisfaction as Predictors of Job Performance in Health Care Workers: The Mediating Role of Work Engagement. Journal of Primary Care & Community Health, 13, 21501319221101845. https://doi.org/10.1177/21501319221101845
• Brewer, E. W., & Shapard, L. (2004). Employee Burnout: A Meta-Analysis of the Relationship Between Age or Years of Experience. Human Resource Development Review, 3(2), 102–123. https://doi.org/10.1177/1534484304263335
• Cammann, C. (1983). Assessing the attitudes and perceptions of organizational members. Assessing Organizational Change : A Guide to Methods, Measures, and Practices, 71–138.
• Carney, P. A., Thayer, E. K., Palmer, R., Galper, A. B., Zierler, B., & Eiff, M. P. (2019). The benefits of interprofessional learning and teamwork in primary care ambulatory training settings. Journal of Interprofessional Education & Practice, 15, 119–126. https://doi.org/10.1016/j.xjep.2019.03.011
• Carson, O. M., Laird, E. A., Reid, B. B., Deeny, P. G., & McGarvey, H. E. (2018). Enhancing teamwork using a creativity-focussed learning intervention for undergraduate nursing students—A pilot study. Nurse Education in Practice, 30, 20–26. https://doi.org/10.1016/j.nepr.2018.02.008
• Chang, W.-Y., Ma, J.-C., Chiu, H.-T., Lin, K.-C., & Lee, P.-H. (2009). Job satisfaction and perceptions of quality of patient care, collaboration and teamwork in acute care hospitals. Journal of Advanced Nursing, 65(9), 1946–1955. https://doi.org/10.1111/j.1365-2648.2009.05085.x
• Chen, I.-H., Brown, R., Bowers, B. J., & Chang, W.-Y. (2015). Work-to-family conflict as a mediator of the relationship between job satisfaction and turnover intention. Journal of Advanced Nursing, 71(10), 2350–2363. https://doi.org/10.1111/jan.12706
• Cohen, G., Blake, R. S., & Goodman, D. (2016). Does Turnover Intention Matter? Evaluating the Usefulness of Turnover Intention Rate as a Predictor of Actual Turnover Rate. Review of Public Personnel Administration, 36(3), 240–263. https://doi.org/10.1177/0734371X15581850
• Collini, S. A., Guidroz, A. M., & Perez, L. M. (2015). Turnover in health care: The mediating effects of employee engagement. Journal of Nursing Management, 23(2), 169–178. https://doi.org/10.1111/jonm.12109
• Costa, C., & Lusk, P. (2017). Perceptions of Interdisciplinary Communication Among Correctional Health Care Providers. Journal of Correctional Health Care, 23(1), 122–130. https://doi.org/10.1177/1078345816686064
• Cruz-Gomes, S., Amorim-Lopes, M., & Almada-Lobo, B. (2018). The demand for healthcare services and resources: patterns, trends and challenges in healthcare delivery. In Congress of APDIO, the Portuguese Operational Research Society (pp. 91-106). Cham: Springer International Publishing.
• Darkwa, E. K., Newman, M. S., Kawkab, M., & Chowdhury, M. E. (2015). A qualitative study of factors influencing retention of doctors and nurses at rural healthcare facilities in Bangladesh. BMC Health Services Research, 15(1), 344. https://doi.org/10.1186/s12913-015-1012-z
• Dodge, L. E., Nippita, S., Hacker, M. R., Intondi, E. M., Ozcelik, G., & Paul, M. E. (2021). Long-term effects of teamwork training on communication and teamwork climate in ambulatory reproductive health care. Journal of Healthcare Risk Management, 40(4), 8–15. https://doi.org/10.1002/jhrm.21440
• Gaston, T., Short, N., Ralyea, C., & Casterline, G. (2016). Promoting Patient Safety: Results of a TeamSTEPPS® Initiative. JONA: The Journal of Nursing Administration, 46(4), 201. https://doi.org/10.1097/NNA.0000000000000333
• González-Gancedo, J., Fernández-Martínez, E., & Rodríguez-Borrego, M. A. (2019). Relationships among general health, job satisfaction, work engagement and job features in nurses working in a public hospital: A cross-sectional study. Journal of Clinical Nursing, 28(7–8), 1273–1288. https://doi.org/10.1111/jocn.14740
• Hackman, J. R., & Oldham, G. R. (1975). Development of the Job Diagnostic Survey. Journal of Applied Psychology, 60(2), 159–170. https://doi.org/10.1037/h0076546
• Hair, J. F., Babin, B. J., Anderson, R. E., & Black, W. C. (2019). Multivariate data analysis (8th ed.). Pearson.
• Hall-Lord, M. L., Skoogh, A., Ballangrud, R., Nordin, A., & Bååth, C. (2020). The Swedish Version of the TeamSTEPPS® Teamwork Perceptions Questionnaire (T-TPQ): A Validation Study. Journal of Multidisciplinary Healthcare, 13, 829–837. https://doi.org/10.2147/JMDH.S261768
• Hanaysha, J., & Tahir, P. R. (2016). Examining the Effects of Employee Empowerment, Teamwork, and Employee Training on Job Satisfaction. Procedia - Social and Behavioral Sciences, 219, 272–282. https://doi.org/10.1016/j.sbspro.2016.05.016
• Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6(1), 1–55. https://doi.org/10.1080/10705519909540118
• Judge, T. A., Zhang, S. C., & Glerum, D. R. (2020). Job satisfaction. Essentials of job attitudes and other workplace psychological constructs, 207-241.
• Kang, H.-C., & Hong, J.-S. (2011). Do differences in profiling criteria bias performance measurements? Economic profiling of medical clinics under the Korea National Health Insurance program: An observational study using claims data. BMC Health Services Research, 11(1), 189. https://doi.org/10.1186/1472-6963-11-189
• Körner, M., Wirtz, M. A., Bengel, J., & Göritz, A. S. (2015). Relationship of organizational culture, teamwork and job satisfaction in interprofessional teams. BMC Health Services Research, 15(1), 243. https://doi.org/10.1186/s12913-015-0888-y
• Lacity, M. C., Iyer, V. V., & Rudramuniyaiah, P. S. (2008). Turnover intentions of Indian IS professionals. Information Systems Frontiers, 10(2), 225-241.
• Lakatamitou, I., Lambrinou, E., Kyriakou, M., Paikousis, L., & Middleton, N. (2020). The Greek versions of the TeamSTEPPS teamwork perceptions questionnaire and Minnesota satisfaction questionnaire “short form.” BMC Health Services Research, 20(1), 587. https://doi.org/10.1186/s12913-020-05451-8
• Lisbon, D., Allin, D., Cleek, C., Roop, L., Brimacombe, M., Downes, C., & Pingleton, S. K. (2016). Improved Knowledge, Attitudes, and Behaviors After Implementation of TeamSTEPPS Training in an Academic Emergency Department: A Pilot Report. American Journal of Medical Quality, 31(1), 86–90. https://doi.org/10.1177/1062860614545123
• López-Cabarcos, M. Á., López-Carballeira, A., & Ferro-Soto, C. (2019). The role of emotional exhaustion among public healthcare professionals. Journal of Health Organization and Management, 33(6), 649–655. https://doi.org/10.1108/JHOM-04-2019-0091
• Neuman, W. L. (2014). Social Research Methods: Qualitative and Quantitative Approaches. 7th Edition, Pearson, Boston.
• Pignault, A., Vayre, E., & Houssemand, C. (2022). What Do They Want from a Career? University Students’ Future Career Expectations and Resources in a Health Crisis Context. Sustainability, 14(24), Article 24. https://doi.org/10.3390/su142416406
• Rehder, K. J., Adair, K. C., Hadley, A., McKittrick, K., Frankel, A., Leonard, M., Frankel, T. C., & Sexton, J. B. (2020). Associations Between a New Disruptive Behaviors Scale and Teamwork, Patient Safety, Work-Life Balance, Burnout, and Depression. The Joint Commission Journal on Quality and Patient Safety, 46(1), 18–26. https://doi.org/10.1016/j.jcjq.2019.09.004
• Riess, T. H., Achieng’, M. M., Otieno, S., Ndinya-Achola, J. O., & Bailey, R. C. (2010). “When I Was Circumcised I Was Taught Certain Things”: Risk Compensation and Protective Sexual Behavior among Circumcised Men in Kisumu, Kenya. PLOS ONE, 5(8), e12366. https://doi.org/10.1371/journal.pone.0012366
• Roche, M. A., Duffield, C. M., Homer, C., Buchan, J., & Dimitrelis, S. (2015). The rate and cost of nurse turnover in Australia. Collegian, 22(4), 353–358. https://doi.org/10.1016/j.colegn.2014.05.002
• Rossi, R., Socci, V., Pacitti, F., Di Lorenzo, G., Di Marco, A., Siracusano, A., & Rossi, A. (2020). Mental Health Outcomes Among Frontline and Second-Line Health Care Workers During the Coronavirus Disease 2019 (COVID-19) Pandemic in Italy. JAMA Network Open, 3(5), e2010185. https://doi.org/10.1001/jamanetworkopen.2020.10185
• Rowan, B. L., Anjara, S., De Brún, A., MacDonald, S., Kearns, E. C., Marnane, M., & McAuliffe, E. (2022). The impact of huddles on a multidisciplinary healthcare teams’ work engagement, teamwork and job satisfaction: A systematic review. Journal of Evaluation in Clinical Practice, 28(3), 382–393. https://doi.org/10.1111/jep.13648
• Schmutz, J. B., Meier, L. L., & Manser, T. (2019). How effective is teamwork really? The relationship between teamwork and performance in healthcare teams: a systematic review and meta-analysis. BMJ Open, 9(9), e028280. https://doi.org/10.1136/bmjopen-2018-028280
• Skoogh, A., Bååth, C., & Hall-Lord, M. L. (2022). Healthcare professionals’ perceptions of patient safety culture and teamwork in intrapartum care: A cross-sectional study. BMC Health Services Research, 22(1), 820. https://doi.org/10.1186/s12913-022-08145-5
• Sungur, C., Özer, Ö., Saygili, M., & Uğurluoğlu, Ö. (2019). Paternalistic Leadership, Organizational Cynicism, and Intention to Quit One’s Job in Nursing. Hospital Topics, 97(4), 139–147. https://doi.org/10.1080/00185868.2019.1655509.
• Tabachnick, B. G., & Fidell, L. S. (2007). Experimental designs using ANOVA. Thomson/Brooks/Cole.
• Tamata, A. T., & Mohammadnezhad, M. (2023). A systematic review study on the factors affecting shortage of nursing workforce in the hospitals. Nursing Open, 10(3), 1247–1257. https://doi.org/10.1002/nop2.1434
• Wiedermann, C. J., Barbieri, V., Engl, A., & Piccoliori, G. (2024). Impact of Relational Coordination on Job Satisfaction and Willingness to Stay: A Cross-Sectional Survey of Healthcare Professionals in South Tyrol, Italy. Behavioral Sciences, 14(5), Article 5. https://doi.org/10.3390/bs14050397
• Willard-Grace, R., Knox, M., Huang, B., Hammer, H., Kivlahan, C., & Grumbach, K. (2019). Burnout and Health Care Workforce Turnover. The Annals of Family Medicine, 17(1), 36–41. https://doi.org/10.1370/afm.2338
• Winter, V., Schreyögg, J., & Thiel, A. (2020). Hospital staff shortages: Environmental and organizational determinants and implications for patient satisfaction. Health Policy, 124(4), 380–388. https://doi.org/10.1016/j.healthpol.2020.01.001
• Wong, A. H.-W., Gang, M., Szyld, D., & Mahoney, H. (2016). Making an “Attitude Adjustment”: Using a Simulation-Enhanced Interprofessional Education Strategy to Improve Attitudes Toward Teamwork and Communication. Simulation in Healthcare, 11(2), 117. https://doi.org/10.1097/SIH.0000000000000133
• Yilmaz, C. (2020). Validity and reliability analysis of the Teamwork Perceptions Questionnaire in the Turkish context (Unpublished master’s thesis). Sosyal Bilimler Enstitüsü.
• Zaheer, S., Ginsburg, L., Wong, H. J., Thomson, K., Bain, L., & Wulffhart, Z. (2019). Turnover intention of hospital staff in Ontario, Canada: Exploring the role of frontline supervisors, teamwork, and mindful organizing. Human Resources for Health, 17(1), 66. https://doi.org/10.1186/s12960-019-0404-2
• Zaheer, S., Ginsburg, L., Wong, H. J., Thomson, K., Bain, L., & Wulffhart, Z. (2021). Acute care nurses’ perceptions of leadership, teamwork, turnover intention and patient safety – a mixed methods study. BMC Nursing, 20(1), 134. https://doi.org/10.1186/s12912-021-00652-w