Table 5.
Effect of the Structural Capability Index on NP Burnout, Job Dissatisfaction, and Intent to Leave
| Burnout | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
|
| ||||||||||||
| Model 1: Unadjusted | Model 2: NP and Practice Characteristics | Model 3: Work Environment | Model 4: Interaction | |||||||||
|
|
||||||||||||
| β (95% CI) | Percentage point change | P | β (95% CI) | Percentage point change | P | β (95% CI) | Percentage point change | P | β (95% CI) | Percentage point change | P | |
| Structural Capability Index (SCI) | −0.27 (−0.39, −0.15) |
−2.67 | <.001 | −0.30 (−0.42, −0.18) |
−3.01 | <.001 | −0.11 (−0.23, 0.01) |
−1.07 | .082 | −0.80 (−1.56, −0.04) |
−8.00 | .040 |
| Work Environment | -- | -- | -- | -- | -0.28 (−0.34, −0.23) |
-- | <.001 | −.40 (−.53, −.27) |
-- | <.001 |
||
| SCI x Work Environment | -- | -- | -- | -- | -- | -- | .21 (−0.01, 0.43) |
-- | .058 | |||
|
| ||||||||||||
| Job Dissatisfaction | ||||||||||||
|
| ||||||||||||
| Model 1: Unadjusted | Model 2: NP and Practice Characteristics | Model 3: Work Environment | Model 4: Interaction | |||||||||
|
|
||||||||||||
| β (95% CI) | Percentage point change | P | β (95% CI) | Percentage point change | P | β (95% CI) | Percentage point change | P | β (95% CI) | Percentage point change | P | |
|
|
||||||||||||
| Structural Capability Index (SCI) | −0.17 (−0.25, −0.09) |
−1.69 | <.001 | −0.18 (−0.26, −0.09) |
−1.76 | <.001 | −0.04 (−0.12, 0.04) |
−0.04 | .284 | −0.88 (−1.52, −0.24) |
−8.79 | .008 |
| Work Environment | -- | -- | -- | -- | -0.19 (−0.24, −0.15) |
-- | <.001 | −0.33 (−0.45, −0.22) |
-- | <.001 | ||
| SCI x Work Environment | -- | -- | -- | -- | -- | -- | 0.26 (0.07, 0.44) |
-- | .006 | |||
|
| ||||||||||||
| Intent to Leave | ||||||||||||
|
| ||||||||||||
| Model 1: Unadjusted | Model 2: NP and Practice Characteristics | Model 3: Work Environment | Model 4: Interaction | |||||||||
|
|
||||||||||||
| β (95% CI) | Percentage point change | P | β (95% CI) | Percentage point change | P | β (95% CI) | Percentage point change | P | β (95% CI) | Percentage point change | P | |
|
| ||||||||||||
| Structural Capability Index (SCI) | -0.29 (−0.40, −0.18) |
-2.87 | <.001 | -0.33 (−0.44, −0.22) |
-3.32 | <.001 | -0.15 (−0.26, −0.05) |
-1.55 | .006 | -0.81 (−1.55, −0.07) |
-8.12 | .032 |
| Work Environment | -- | -- | -- | -- | -0.26 (−0.31, −0.21) |
-- | <.001 | -0.37 (−0.50, −0.24) |
-- | <.001 | ||
|
| ||||||||||||
| SCI x Work Environment | -- | -- | -- | -- | -- | -- | 0.20 (−0.01, 0.42) |
-- | .065 | |||
Abbreviations: SCI = Structural Capability Index, β = Beta Coefficient, CI = Confidence Interval, P = p value.Notes: Coefficients and p values generated from linear probability models. Model 1: Unadjusted relationship between SCI and NP burnout/job dissatisfaction/intent to leave. Model 2: Add NP characteristics (i.e., age, sex, race, ethnicity, marital status, education, years of experience, hours/week, managed own panel) and primary care practice characteristics (i.e., practice type, scope of practice, number of nurse practitioners) to Model 1. Model 3: Add work environment to Model 2. Model 4: Add interaction of SCI x Work Environment to Model 3. To interpret the findings produced by the linear probability models, we applied the transformations described in theData Analysis section. We report the percentage point change in the probability of the outcome = 1 corresponding to a 0.1-unit increase in SCI score.