Table 3. Associations Between Individual and Organizational Factors and Intention to Leave.
| Independent variablea and modelb | Odds ratio (95% CI) | P value | Bonferroni-adjusted P value | Nagelkerke pseudo R2 |
|---|---|---|---|---|
| Burnoutc | ||||
| Model 0 | 1.48 (1.45-1.50) | <.001 | <.001 | 0.15 |
| Model 1 | 1.52 (1.49-1.55) | <.001 | <.001 | 0.19 |
| Model 2a | 1.24 (1.20-1.27) | <.001 | <.001 | 0.25 |
| Professional fulfillmentc | ||||
| Model 0 | 0.66 (0.65-0.67) | <.001 | <.001 | 0.19 |
| Model 1 | 0.64 (0.63-0.65) | <.001 | <.001 | 0.23 |
| Model 2b | 0.72 (0.71-0.74) | <.001 | <.001 | 0.25 |
| Sleep-related impairment (4-item) | ||||
| Model 0 | 1.18 (1.15-1.20) | <.001 | <.001 | 0.04 |
| Model 1 | 1.19 (1.17-1.21) | <.001 | <.001 | 0.08 |
| Model 2 | 1.02 (1.00-1.05) | .04 | NA | 0.25 |
| Supportive leadership behaviorsc | ||||
| Model 0 | 0.74 (0.73-0.75) | <.001 | <.001 | 0.14 |
| Model 1 | 0.74 (0.72-0.75) | <.001 | <.001 | 0.17 |
| Model 2 | 0.83 (0.82-0.84) | <.001 | <.001 | 0.28 |
| Control over schedule | ||||
| Model 0 | 0.85 (0.83-0.86) | <.001 | <.001 | 0.04 |
| Model 1 | 0.83 (0.81-0.84) | <.001 | <.001 | 0.08 |
| Model 2 | 0.98 (0.96-1.00) | .05 | NA | 0.25 |
| Peer supportc | ||||
| Model 0 | 0.80 (0.79-0.82) | <.001 | <.001 | 0.08 |
| Model 1 | 0.81 (0.79-0.82) | <.001 | <.001 | 0.12 |
| Model 2 | 0.93 (0.91-0.95) | <.001 | <.001 | 0.26 |
| Negative impact of work on personal relationshipsc | ||||
| Model 0 | 1.22 (1.20-1.23) | <.001 | <.001 | 0.10 |
| Model 1 | 1.23 (1.22-1.25) | <.001 | <.001 | 0.14 |
| Model 2 | 1.09 (1.07-1.11) | <.001 | <.001 | 0.26 |
| Self-valuation | ||||
| Model 0 | 0.82 (0.81-0.84) | <.001 | <.001 | .05 |
| Model 1 | 0.81 (0.80-0.83) | <.001 | <.001 | 0.09 |
| Model 2 | 0.98 (0.96-1.01) | .18 | NA | 0.26 |
| Meaningfulness of clinical work | ||||
| Model 0 | 0.83 (0.81-0.85) | <.001 | <.001 | 0.04 |
| Model 1 | 0.82 (0.80-0.84) | <.001 | <.001 | 0.09 |
| Model 2 | 1.06 (1.03-1.10) | <.001 | .003 | 0.27 |
| Personal-organizational values alignmentc | ||||
| Model 0 | 0.71 (0.70-0.72) | <.001 | <.001 | 0.20 |
| Model 1 | 0.71 (0.70-0.72) | <.001 | <.001 | 0.22 |
| Model 2 | 0.81 (0.80-0.82) | <.001 | <.001 | 0.29 |
| Perceived gratitudec | ||||
| Model 0 | 0.79 (0.77-0.80) | <.001 | <.001 | 0.08 |
| Model 1 | 0.78 (0.77-0.80) | <.001 | <.001 | 0.11 |
| Model 2 | 0.95 (0.92-0.97) | <.001 | <.001 | 0.26 |
| COVID-19 organizational supportc | ||||
| Model 0 | 0.77 (0.75-0.80) | <.001 | <.001 | 0.10 |
| Model 1 | 0.76 (0.74-0.79) | <.001 | <.001 | 0.13 |
| Model 2 | 0.88 (0.85-0.91) | <.001 | <.001 | 0.26 |
| Anxiety | ||||
| Model 0 | 1.25 (1.22-1.27) | <.001 | <.001 | 0.05 |
| Model 1 | 1.27 (1.24-1.30) | <.001 | <.001 | 0.08 |
| Model 2 | 1.02 (0.99-1.04) | .21 | NA | 0.25 |
| Depressionc | ||||
| Model 0 | 1.35 (1.33-1.38) | <.001 | <.001 | 0.10 |
| Model 1 | 1.37 (1.34-1.40) | <.001 | <.001 | 0.13 |
| Model 2 | 1.08 (1.05-1.10) | <.001 | <.001 | 0.25 |
| EHR helpfulnessc | ||||
| Model 0 | 0.83 (0.82-0.85) | <.001 | <.001 | 0.04 |
| Model 1 | 0.84 (0.82-0.85) | <.001 | <.001 | 0.07 |
| Model 2 | 0.95 (0.93-0.97) | <.001 | <.001 | 0.25 |
| EHR hassles | ||||
| Model 0 | 1.13 (1.11-1.15) | <.001 | <.001 | 0.03 |
| Model 1 | 1.15 (1.12-1.17) | <.001 | <.001 | 0.07 |
| Model 2 | 1.04 (1.02-1.06) | <.001 | .01 | 0.24 |
Abbreviations: EHR, electronic health record; NA, not applicable.
a
The number of survey respondents who provided responses to measures of each independent variable varied widely, as reported here. This is because each participating organization had flexibility in selecting the survey assessments they wished to include, other than the minimum required assessments of burnout, professional fulfillment, and intention to leave.
b
Model 0 was unadjusted. Model 1 was adjusted demographics. Model 2 was adjusted for demographics, burnout, and professional fulfillment. Model 2a was adjusted for demographics and professional fulfillment. Model 2b was adjusted for demographics and burnout.
c
Significant at a Bonferroni-corrected threshold of P < .001.