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. 2024 Nov 25;81(4):1734–1754. doi: 10.1111/jan.16634

Nurses' Perceptions of Organisational Attractiveness and Related Factors in Health Care: A Mixed Methods Systematic Review

Kirsi Karjalainen 1, Marjo Makkonen 1, Suvi Kuha 1,2, Outi Kanste 1,2,3,✉
PMCID: PMC11896836  PMID: 39582354

ABSTRACT

Aim

To identify and integrate the best evidence on nurses' perceptions of organisational attractiveness and related factors in health care.

Design

A mixed methods systematic review.

Methods

The review followed the Joanna Briggs Institute Mixed Methods Systematic Review methodology and a convergent segregated approach which involved separate qualitative and quantitative syntheses followed by integration in a narrative form.

Data Sources

A systematic search was conducted in August 2023 with no time or geographical limits in CINAHL, PubMed, Finnish database Medic, Scopus, ProQuest, Web of Science, MedNar and EBSCO databases. Studies published in English, Finnish and Swedish were included.

Results

Eleven studies (three qualitative, eight quantitative) were identified and studied further. The results indicated that key themes of organisational attractiveness in health care were the dimensions of patient and professional work well‐being, opportunities for professional growth and the responsibilities of the organisation.

Conclusions

Patient and work well‐being for nurses have a considerable effect on organisational attractiveness. Organisations play a notable role in enabling nurses' professional growth. Responsibilities of the organisation extend to higher political decision‐making as well as to managers of the healthcare organisations. Organisational attractiveness covers the entire organisation, its patients, professionals and managers. Enhancing multi‐professional cooperation, implementing effective management practices and branding of the organisation can contribute to increased organisational attractiveness.

Implications for Practice and Research

Organisations should consider nurses' wishes, develop strategies to improve competencies, leverage social media to develop their brand, extend the orientation to all levels of the organisation and increase interdepartmental and external collaboration. Future research on organisational attractiveness is necessary in health care and the views of healthcare professionals on a wider scale.

Reporting Method

The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines were used when reporting the results.

Patient or Public Contribution

There was no patient or public contribution.

Trial and Protocol Registration

The protocol was registered in the PROSPERO database of the National Institute of Health Research (CRD42023451680).

Keywords: health care, nurses, organisational attractiveness, systematic review

Summary.

  • What Does This Paper Contribute to the Wider Global Clinical Community?
    • ○
      Healthcare workforce shortage is a worldwide phenomenon and healthcare organisations need information about nurses' perceptions of organisational attractiveness and related factors.
    • ○
      This paper identified three main themes describing organisational attractiveness and related factors in health care: the dimensions of patient and professional work well‐being, the opportunities for professional growth and the responsibilities of the organisation.
    • ○
      This paper can help healthcare organisations, leaders and managers to better understand organisational attractiveness, and how it can be enhanced.

1. Introduction

The healthcare workforce shortage is a common and widespread phenomenon, with the latest threat being the COVID‐19 pandemic (Bektas and Kiper 2022; Boniol et al. 2022). Up to 13 million nurses will be needed in the future to fill the shortage gap (ICN 2021). Nurses work in complex organisations that are adaptative systems designed to provide health care to the population (Ratnapalan and Lang 2020). Organisations are highly competitive and should strive to attract employees (Al‐Nawafah et al. 2022) by focusing on the organisational attractiveness (McDaniel, Driebe, and Lanham 2013).

Organisational attractiveness (OA) is considered a crucial factor in attracting and retaining highly qualified employees (Story, Castanheira, and Hartig 2016). The concept of OA can be defined as ‘the degree to which an individual perceives the organization to be a place to work or the general desirability an individual has to work for an organization’ (Williams 2013, 862) or as ‘applicants' willingness to pursue jobs and to accept job offers in an organization’ (Story, Castanheira, and Hartig 2016, 487). OA can be operationalised in terms of instrumental attributes such as salary, benefits or advancement opportunities or symbolic attributes such as reputation and prestige (Firfiray and Mayo 2017; Renaud, Morin, and Fray 2016). It can also be operationalised in terms of relational attributes such as perceived supervisor or organisational support, work–life balance, value congruence, transformational, servant or supportive leadership style, a healthy work atmosphere and authentic workplace culture. OA is also highly dependent on individual characteristics and the alignment of organisational and employee values (Dassler et al. 2022). Perceived attractiveness is a result of individual emphasis on these characteristics (Uggerslev, Fassina, and Kraichy 2012).

OA tends to be higher when organisations demonstrate responsibility towards employees (Carballo‐Penela 2019), work practices are flexible (Khan et al. 2023; Kröll, Nüesch, and Foege 2018), and there is a focus on human resource management (Trybou et al. 2014). OA can lead to reduced turnover intentions (García‐Sierra, Fernández‐Castro, and Martínez‐Zaragoza 2016; Slåtten et al. 2021), better retention and positive work attitudes such as job satisfaction and psychological attachment (Dassler et al. 2022). Additionally, OA can lead to employee commitment and engagement (Dassler et al. 2022), with high‐quality care, respect towards employees and sufficient resources being key drivers (Dempsey and Assi 2018; García‐Sierra, Fernández‐Castro, and Martínez‐Zaragoza 2016). Other outcomes may include positive word‐of‐mouth and positive organisational and individual performance (Dassler et al. 2022). Outcomes of OA may also include compensation expectations (Dassler et al. 2022) and career development, which is also associated with work engagement (Dempsey and Assi 2018) and turnover intentions (Drennan and Ross 2019).

Healthcare organisations are also facing many challenges related to employees' perceptions of OA (Al‐Abrrow et al. 2021). Factors that reduce OA include negative organisational policies perceived by employees (Fast, Burris, and Bartel 2014; Jabbar et al. 2020) and crisis events (Chang, Weng, and Wu 2023; Onken‐Menke et al. 2021). OA provides a frame for employer branding (Kalińska‐Kula and Staniec 2021; Trybou et al. 2014; Wu and Dineen 2022) and contributes to the ability of organisations to distinguish themselves from other organisations (Yadav, Kumar, and Mishra 2020). Employer branding can strengthen the organisations' reputation (Yaghoubi et al. 2017) and help organisations be more dynamic (Yadav, Kumar, and Mishra 2020).

Although some research examines OA at a general level, the results are fragmented. A preliminary search of the PROSPERO, Cochrane, JBI Evidence Synthesis, PubMed, Scopus and CINAHL databases was conducted and no current or in‐progress systematic reviews of OA in health care were identified. One systematic review by Dassler et al. (2022) identified employer attractiveness in business and management. However, such a comprehensive review of organisational attractiveness and related factors especially from the perspective of nurses, is missing. Thus, this review was conducted to fill this identified research gap and to integrate previous knowledge about OA in the healthcare environment. The objective was to add the evidence base of organisational attractiveness in health care and provide comprehensive information that can help organisations to better understand how to be more attractive.

2. The Review

2.1. Aim and Review Questions

The aim of this systematic review was to identify and integrate the best evidence on nurses' perceptions of organisational attractiveness and related factors in health care.

The review questions were

  1. What perceptions do nurses have about organisational attractiveness in health care?

  2. Which patient‐related, work‐related, individual and organisational factors are related to organisational attractiveness in health care?

3. Methods

3.1. Design

A mixed methods systematic review was conducted in accordance with the Joanna Briggs Institute guidelines for mixed methods systematic review (MMSR) following the convergent segregated approach. Mixed methods were used in this review because bringing together qualitative and quantitative evidence can help explain the results and provide a basis to support decision‐making in organisations (Lizarondo et al. 2020). The review was reported using the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses: a PRISMA Statement (Supporting Information S1) (Page et al. 2021). The protocol was registered in the PROSPERO database of the National Institute of Health Research (CRD42023451680).

3.2. Search Methods

A three‐step search strategy was utilised (Peters et al. 2020). The search strategy aimed to find both published and unpublished studies. First, an initial limited search of the PubMed, Medline, Scopus and CINAHL databases was undertaken followed by an analysis of the text words contained in the title and abstract and the index terms used to describe the studies. The search strategy was adapted for each included information source and a second search was undertaken in August 2023 (Supporting Information S2). Keywords were defined according to PICo (participants, phenomena of interest and context; Lizarondo et al. 2020) and PEO (participants, exposure of interest and outcome; Moola et al. 2020) selection criteria. A total of eight databases were used, which included CINAHL, PubMed, the Finnish database Medic, Scopus, ProQuest, Web of Science, MedNar and EBSCO Open dissertations. The reference list of all studies included for review was screened for additional studies. An experienced library information specialist was utilised during the development of the search strategy. Studies published in English, Finnish and Swedish were included. There was no geographical or time limit.

3.3. Inclusion and Exclusion Criteria

The inclusion and exclusion criteria were based on PICo for qualitative studies and PEO for quantitative studies (Table 1). This review considered original quantitative, qualitative and mixed method studies. Participants in eligible studies were nurses working in clinical practice. The outcomes were the results concerning OA in health care. The context included all types of healthcare organisations.

TABLE 1.

Inclusion and exclusion criteria based on PICo for qualitative studies and PEO for quantitative studies.

PICo and PEO Inclusion Exclusion
Participants (P) Nurses, graduating nurses, registered nurses, bachelor's and postgraduate nursing students, physiotherapists a and occupational therapists a Nursing students b leaders, managers and educators
Phenomena of interest (I) Professionals' perceptions of organisational attractiveness
Exposure of interest (E) Patient‐related factors: for example, quality of care
Work‐related factors: for example, type of work
Organisational factors: processes, attributes or conditions within an organisation (Valaitis et al. 2018)
Individual factors: for example, age, gender and education
Context (Co) All types of healthcare organisations
Outcomes (O) Organisational attractiveness in health care
Type of studies Quantitative, qualitative and mixed method studies
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Note: If the participants of a study included professionals other than nurses, the minimum requirement was for the nurses to constitute at least 25% of the participants. Source: Authors' own work.

a

Physiotherapists and occupational therapists were included in one study because they were grouped together with nurses.

b

Bachelor's and postgraduate nursing students were included in one study because the results were grouped together with nurses.

3.4. Search Outcome

The database search yielded a total of 8781 studies. The studies were uploaded into Covidence systematic review software (2023), and 3862 duplicates were removed. Four independent reviewers (KK, MM, SK and OK) screened 4919 titles and abstracts and excluded 4733 studies. The full texts of 186 studies were reviewed by three independent reviewers (KK, MM and SK) and of these 175 studies did not meet the inclusion criteria and were excluded (Figure 1). One article was identified manually from references. No unpublished studies were retrieved. A total of 11 studies were included in the critical appraisal. Any disagreements were resolved through discussion or with a third reviewer. More information about the reasons for exclusion can be requested from the corresponding author.

FIGURE 1.

FIGURE 1

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PRISMA flow diagram (Page et al. 2021). Source: Authors' own work.

3.5. Quality Appraisal

Eligible studies were critically appraised by two independent reviewers (KK and MM) for methodological quality using the JBI standardised critical appraisal instruments for qualitative studies (Lockwood, Munn, and Porritt 2015; Supporting Information S3) and quantitative studies (Moola et al. 2020; Supporting Information S4). The author of one study was contacted via e‐mail to request clarification about the number of participants. The agreement rate in quality appraisal between the two independent reviewers was 73%. Any disagreements raised between the reviewers were resolved through discussion, or with a third reviewer. All studies regardless of their methodological quality were included in the review. All studies received 50% or more of the quality assessment points.

3.6. Data Extraction

Data were extracted by two independent reviewers (KK and MM) and cross‐checked by third reviewer (SK) using Microsoft Word (Table 2). The data included details about the authors, year, country, purpose, participants, design, data collection, data analysis and key findings. Any disagreements that were raised between the reviewers were resolved through discussion.

TABLE 2.

Data extraction.

Author(s), year and country Purpose Participants Design, data collection and analysis Key findings Quality appraisal a
De Groot, Maurits, and Francke (2018), The Netherlands To gain in‐depth knowledge about which aspects of homecare nurses find attractive about their work and to explore whether these aspects vary for homecare nurses with different levels of education Registered Dutch nurses (n = 38) who are A qualitative study. Explorative design. The study identified that homecare nurses find it attractive that (1) they are a ‘linchpin’, in the sense of being the leading professional and the patient as the centre of care; (2) having autonomy is attractive; autonomy over decision‐making about care, freedom in work scheduling and working in a self‐directed team and (3) variety in patient situations and activities is also attractive JBI Critical Appraisal Checklist for Qualitative Research 7/10

  1. Registered nurses with a bachelor's degree or an associate degree in nursing

 Online focus groups (OFGs), interviews based on discussion
  • 2

    Currently providing home care and

 Thematic analysis
  • 3

    Having access to and being able to use a device with an Internet connection
Keisu (2017), Sweden To critically explore discourses of NPM (new public management) and dignity in and at work by focusing on how attractive work is represented by managers and professionals in Swedish elderly care Middle managers (n = 4), first‐level managers (n = 10), nurses (n = 5), physiotherapists (n = 6) and occupational therapists (n = 6) working in nine different elderly care institutions in four Swedish regions A qualitative study Grounded theory The study identified three storylines of how attractive work is represented: (1) salary and status, (2) high‐quality care, providing patients with activity and rehability and (3) working conditions and competence; autonomy, how work is performed, support from managers, how health care is governed, professional development, good working climate, joy of work JBI Critical Appraisal Checklist for Qualitative Research 8/10
Nurses, physiotherapists and occupational therapists were referred to as ‘professionals’ in the analysis 31 semi‐structured interviews
Critical discursive psychology
Prentice and Black (2007), Canada To explore the reasons why RNs (registered nurses) choose to work in nursing homes, a type of LTC (long‐term care) facility and why did they stay. Registered nurses (n = 9) working in three nursing homes in Southern Ontario, Canada A qualitative study. A case study approach. The study identified six sub‐themes which were (1) job of choice, joy with working with patients; (2) job of convenience; (3) caring for the residents; (4) supportive environment, flexible work scheduling practices, the presence of supportive colleagues, professional development and education, a balanced home‐life and work life; (5) heavy workload and (6) supervisory role of the RN. Heavy workload and supervisory role lower OA JBI Critical Appraisal Checklist for Qualitative Research 8/10
In‐depth interviews using a semi‐structured interview guide
Data analysis according to Miles and Huberman
Björn, Lindberg, and Rissen (2015), Sweden To examine significant factors for work attractiveness and how these differ from the current work situation among operating department nurses Eligible nurses working in the operating departments of four hospitals in Sweden (n = 147) A quantitative study. Correlational, cross‐sectional survey study The study identified that the most significant attractive factors were (1) relationships, (2) leadership and (3) status (all 4.7 SD 0.4). A statistically significant positive correlation between work engagement and attractive work was found (τ = 0.352, p < 0.001). The independent variables work of engagement (p < 0.001) and older age (p < 0.01) significantly predicted work attractiveness JBI Critical Appraisal checklist for analytical cross‐sectional studies 5/8
To examine the associations between age, gender, length of employment, work engagement, work ability, self‐related health indicators and attractiveness of the current work situation The 17‐item scale version of the Utrecht Work Engagement Scale Instrument (UWES), a 7‐point scale
The Work Ability Index (WAI) questionnaire a 3‐point verbal scale.
The Short Form SF36 Health Survey; a 5‐point verbal scale
Borg CR‐10 scale, ranges from 0 to 10
The Attractive Work Questionnaire (AWQ), a 5‐point Likert Scale
Correlation and regression analyses
Buchelt et al. (2021), Poland To assess the importance of various factors influencing medical personnel's perception of a hospital's attractiveness as an employer Participants were directors (n = 285), hybrid doctor managers (n = 285), hybrid nurse managers (n = 285), physicians (n = 285) and nurses (n = 285) from Polish hospitals A quantitative study. A multi‐perspective research design using a contextual approach. For nurses, the most important features of a good employer were (1) nice work atmosphere (4.56), (2) regular payment of remuneration (on time) (4.55) and (3) good relationships with colleagues (4.53) JBI Critical Appraisal checklist for analytical cross‐sectional studies 4/8
A 18‐item scale questionnaire, a 5‐point Likert scale
Statistica 13 software application
Chi‐square test and the V‐Cramer coefficient
Kruskal–Wallis rank test
Carpentier et al. (2017), Belgium To examine whether hospitals' presence on social media can positively affect nurses' perceptions of employer brand and OA and to find out whether these effects can be explained by interactivity and social presence Bachelor's and postgraduate students enrolled at one vocational college located in the same region as the hospital in Belgium (n = 118) A quantitative study. A between‐subjects experimental design The study identified that nurses in the Facebook condition reported more positive perceptions of the hospital's (1) advancement opportunities (β = 0.15, p < 0.05), (2) task diversity (β = 0.14, p < 0.05), (3) work atmosphere (β = 0.14, p < 0.05), (4) competence (β = 0.24, p < 0.01), (5) innovativeness (β = 0.22, p < 0.01) and (6) sincerity (β = 0.22, p < 0.01) JBI Critical Appraisal checklist for analytical cross‐sectional studies 6/8
Employed nurses (n = 94), recruiting using a snowball effect An online questionnaire that assessed OA, interactivity, social presence and employer brand image Nurses in the LinkedIn condition showed more positive perceptions of (1) advancement opportunities (β = 0.29, p < 0.01), (2) task diversity (β = 0.21, p < 0.01), (3) work atmosphere (β = 0.17, p < 0.05), (4) work–life balance (β = 0.23, p < 0.01), (5) competence (β = 0.25, p < 0.01) and (6) innovativeness (β = 0.22, p < 0.01). Social presence plays an important role in explaining the effects of social media
SPSS for Windows; linear regression analyses
Hayes Process Macro in SPSS to apply a bootstrapping method
Fréchette, Bourhis, and Stachura (2013), Canada To contribute to the research literature on the topic of OA by exploring the perspectives of graduating nursing students. The purpose was to answer which job and organisational characteristics act as important organisational attraction factors for Quebec's nursing graduates Graduating nursing students in Quebec, Canada (n = 666) A quantitative study. A cross‐sectional survey study The study identified that important factors of organisational attraction are (1) quality of care (4.11, SD 0.49), (2) type of work (3.96, SD 0.49), (3) compensation (3.92, SD 0.52) and (4) employer branding (3.55, SD 0.46). Quality of care was the most important factor. All variables had a mean score above 3.00 JBI Critical Appraisal checklist for analytical cross‐sectional studies 4/8
A questionnaire based on several existing tools. A 5‐point Likert‐type scale. Analysis of variance, the contrast test and Tukey method of post hoc analysis
Peltokoski et al. (2015), Finland To examine the relationship of a comprehensive healthcare orientation process with a hospital's attractiveness Registered nurses (n = 145) and physicians (n = 37) working in two specialised hospital districts in Finland A quantitative study. A cross‐sectional survey study The study identified that (1) the orientation process is related to OA and it is valued throughout the hospital, (2) responsibilities for orientation are shared between the newcomer, team members, preceptors, managers and hospital administrators, (3) the hospital orientation process is valued by registered nurses through discussions and interactions with colleagues. There is an association between OA and intention to stay. The newcomers' baseline knowledge and adapting responsibilities for tasks during orientation are not as valued JBI Critical Appraisal checklist for analytical cross‐sectional studies 5/8
Orientation Process Evaluation (OPE) Questionnaire
A 5‐point Likert scale for subscales, a scale from 4 to 10 for the hospital's attractiveness
A Naive Bayes Classification
SPSS for Windows
NBC tool b‐course
Slåtten and Lien (2021), Norway To examine the factors related to OA a concept originating in the strategy of employer branding Nurses working in public hospitals in southeast Norway (n = 164) A quantitative study The study identified that (1) interdepartmental collaboration climate (β = 0.244), (2) management support and (β = 0.353) and (3) service quality of care (β = 0.252) has a positive effect on OA, with the three factors explaining 45% (R2 = 0.45) variance in OA. The relationship between management support and OA was found to be mediated through the interdepartmental collaboration climate and that between the interdepartmental collaboration climate and OA was found to be mediated through the service quality of care JBI Critical Appraisal checklist for analytical cross‐sectional studies 4/8
A cross‐sectional survey study
A questionnaire using Checkbox software. 7‐point Likert scale
Confirmatory factor analysis and structural equation modelling (SEM), in Stata. Multi‐group comparisons to test heterogeneity in personal characteristics. Mediator analyses to test indirect effect
Slåtten, Lien, and Svenkerud (2019), Norway To clarify how the role of OA relates to frontline employees' perception of their internal market‐oriented culture (IMOC) as well as their turnover rate, engagement and service quality Nurses working in public hospitals in southeast Norway (n = 164) A quantitative study. A cross‐sectional survey study The study identified that (1) OA has a significant positive effect on frontline employees' work engagement (β = 0.833) and the service quality (β = 0.472), (2) OA significantly lowers turnover rate (β = −0.729), (3) the internal market‐oriented culture (IMOC) has a significantly positive effect on OA (β = 0.587) JBI Critical Appraisal checklist for analytical cross‐sectional studies 4/8
A questionnaire using Checkbox software. 7‐point Likert scale OA fully mediates the relationship between IMOC, frontline employees' engagement and the service quality they provide to patients, and it partially mediates the relationship with the turnover rate
Confirmatory factor analysis and structural equation modelling (SEM) in Stata. Multi‐group comparisons to test heterogeneity in personal characteristics. Mediator analyses to test indirect effects
Van Hoye (2012), Belgium To investigate job‐seeking nurses' exposure to recruitment sources and their attraction to recruiting hospitals Job‐seeking nurses in Belgium (n = 184) A quantitative study. A cross‐sectional survey study The study identified that (1) job seekers who spend more time on receiving employment information through experiential recruitment sources (17.1%), F (4, 175) = 9.14, p < 0.001 such as events and word of mouth perceive this information as more credible, (2) job seekers' exposure to word of mouth was strongly positively related to their attraction to organisations as an employer, (3) credibility explained a substantial amount of additional variance (14.4%), F (1, 174) = 37.20, p < 0.001 JBI Critical Appraisal checklist for analytical cross‐sectional studies 4/8
A questionnaire that measures recruitment sources, credibility and OA. 5‐point Likert scale. Means, standard deviations, correlations and multiple regression analyses
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a

Qualitative studies were evaluated out of a maximum score of 10 and quantitative out of eight.

3.7. Synthesis

This review followed a convergent segregated approach to synthesis and integration according to the JBI methodology for MMSR. Both the qualitative and quantitative findings were analysed using a narrative synthesis followed by integration. The integration was conducted by juxtaposing and organising the qualitative and quantitative evidence into a line of argument to produce an overall analysis in a narrative form (Lizarondo et al. 2020). The results were integrated by combining similar and related results into groups forming three themes. The meta‐analysis was not possible due to the heterogeneity of the instruments used to measure OA.

4. Results

4.1. Characteristics of Studies

The studies included in the review were conducted in Belgium (n = 2), Canada (n = 2), Norway (n = 2), Sweden (n = 2), Finland (n = 1), Poland (n = 1) and the Netherlands (n = 1). The participants of the studies were nurses (n = 1043), graduating nurses (n = 666), registered nurses (n = 192), bachelor's and postgraduate nursing students (n = 118), physiotherapists (n = 6) and occupational therapists (n = 6).

The studies were conducted in hospitals (n = 6), home care (n = 1), elderly care (n = 1), nursing homes (n = 1), operating departments (n = 1) and healthcare organisations in general (n = 1). The study designs used were cross‐sectional survey studies (n = 5), an explorative design (n = 1), grounded theory (n = 1), a case study (n = 1), a multi‐perspective design (n = 1), a between‐subjects experimental design (n = 1) and a field study (n = 1). Data were collected with questionnaires (n = 8) and interviews (n = 3).

4.2. Perceptions of Organisational Attractiveness in the Qualitative Evidence

The qualitative evidence revealed perceptions of organisational attractiveness which consisted of three themes: patient‐centred, work‐centred and organisation‐centred perceptions (Table 3).

TABLE 3.

Findings of the qualitative evidence.

Perceptions of organisational attractiveness
Patient‐centred perceptions Work‐centred perceptions Organisation‐centred perceptions
• Patient being the centre of care • Nurse supervisory role a • How objectives are formulated
• Variety in patient situations • Being a leading professional • How politicians govern health care
• Activities • Work autonomy: being able to schedule activities and set priorities, autonomy over patient care, flexible work scheduling practices • Long‐term strategies to ensure workers' competence
• Providing patients with rehabilitation • Status • Organisational autonomy: working in self‐directed teams, the trust of higher authorities, access to appropriate facilities
• Joy with working with patients • A balanced home‐life and work life • Support from the first‐level manager
• Providing care for older people • A moderate amount of time spent keeping medical records • Higher salaries
• Developing relationships with patients and their families • Heavy workload a • Working in homecare services due to geographical isolation a
• Making a difference in patients' lives • Professional development and education
• A good working climate
• Supportive colleagues
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Source: Authors' own work.

a

Decreases organisational attractiveness.

4.2.1. Patient‐Centred Perceptions of Organisational Attractiveness

Patient‐centred perceptions of OA included patient‐centred care (De Groot, Maurits, and Francke 2018), patient engagement (De Groot, Maurits, and Francke 2018; Keisu 2017) and joy and satisfaction in patient care (Keisu 2017; Prentice and Black 2007). According to Dutch and Swedish nurses, the patient being the centre of care, variety in patient situations (De Groot, Maurits, and Francke 2018) and activities (De Groot, Maurits, and Francke 2018; Keisu 2017) were important to OA. Complementing these results, Swedish nurses acknowledged that providing patients with rehabilitation in nursing homes and hospital wards contributed to increased OA (Keisu 2017). In terms of OA, nurses highlighted the importance of joy in working with patients (Keisu 2017; Prentice and Black 2007), providing care for older people, developing relationships with the patients and their families and making a difference in the patients' lives (Prentice and Black 2007).

4.2.2. Work‐Centred Perceptions of Organisational Attractiveness

Work‐centred perceptions of OA included occupational roles (De Groot, Maurits, and Francke 2018; Prentice and Black 2007), work autonomy (De Groot, Maurits, and Francke 2018; Keisu 2017), balance and flexibility (Prentice and Black 2007), professional development and work environment (Keisu 2017; Prentice and Black 2007). Working in a nurse supervisory role was considered to diminish OA due to increased responsibilities and concerns that the tasks delegated to the healthcare aides were not being done properly (Prentice and Black 2007). In contrast, in a study conducted in the Netherlands, homecare nurses found it attractive that they were a ‘linchpin’ in the sense of being the leading professional (De Groot, Maurits, and Francke 2018). Additionally, nurses found it attractive when they had work autonomy, both individual and team autonomy (De Groot, Maurits, and Francke 2018; Keisu 2017). Work autonomy included being able to schedule activities and set priorities (De Groot, Maurits, and Francke 2018). It also consisted of autonomy over patient care (De Groot, Maurits, and Francke 2018; Keisu 2017) with a relatively autonomous role in decision‐making about the care needed (De Groot, Maurits, and Francke 2018) and how the work is performed (Keisu 2017). Canadian nurses also emphasised the importance of flexible work scheduling practices in attracting them to work in a nursing home (Prentice and Black 2007).

According to Swedish nurses, the meaning of OA was constructed through status in the labour market (Keisu 2017). Further, a balanced home‐life and work life was a key factor of OA for registered nurses in Canadian nursing homes (Prentice and Black 2007). A moderate amount of time spent keeping medical records was found to be attractive (Keisu 2017), while a heavy workload was considered to lower OA, as nurses felt overworked and unable to meet the standards of care (Prentice and Black 2007).

Nurses' need for regular professional development and education was also essential to increase OA (Keisu 2017; Prentice and Black 2007). Furthermore, nurses emphasised the importance of a good working climate (Keisu 2017) and the presence of supportive colleagues (Prentice and Black 2007) as crucial factors contributing to a positive perception of OA.

4.2.3. Organisation‐Centred Perceptions of Organisational Attractiveness

Organisation‐centred perceptions of OA included policies and strategies (Keisu 2017), organisational autonomy (De Groot, Maurits, and Francke 2018), trust and support from managers (De Groot, Maurits, and Francke 2018; Keisu 2017) and compensation (Keisu 2017). Swedish elderly care nurses showed a broad understanding of OA by highlighting how objectives are formulated in the organisation and how politicians govern health care. They also underscored the significance of having long‐term strategies in the organisation to ensure workers' competence (Keisu 2017). In the Netherlands, organisational autonomy was perceived positively in the context of working in self‐directed teams. Working in self‐directed teams made work more independent, and thus increased OA. Homecare nurses highlighted that the trust of higher authorities and access to appropriate facilities also increased OA (De Groot, Maurits, and Francke 2018). Furthermore, Swedish nurses working in elderly care facilities expressed that proper support from the first‐level manager was emphasised as a crucial factor contributing to a positive perception of OA. The meaning of OA was also constructed through higher salaries in the labour market. Nurses also expressed that working in homecare services would lower OA due to perceived geographical isolation (Keisu 2017).

4.3. Related Factors of Organisational Attractiveness in the Quantitative Evidence

The quantitative evidence revealed related factors of OA that were divided into four themes: patient‐related, work‐related, individual and organisational factors (Table 4).

TABLE 4.

Findings of the quantitative evidence.

Patient‐related factors Work‐related and individual factors Organisational factors
• Quality of care • The type of work (hospital's presence on social media on organisational attractiveness considering task diversity, meaningfulness a ) • Employer branding
• The service quality of care • Nurse‐to‐patient ratio • Recruitment sources (word of mouth, recruitment advertising, recruitment events, publicity)
• Service quality provision • Presence on social media on organisational attractiveness considering work–life balance • Credibility
• Older age • Presence on social media on organisational attractiveness considering innovativeness, sincerity and prestige a
• Employment time a • Leadership and management support
• Work ability a • Internal market‐oriented culture
• General health a • Employment security (stability) (hospital's presence on social media on organisational attractiveness considering robustness a )
• The intensity of neck or lower back pain a • Compensation (presence on social media on organisational attractiveness considering meaningfulness of payment a )
• Gender a • Work engagement
• Status • Intention to stay
• Presence on social media on organisational attractiveness considering advancement opportunities, competence • Turnover intentions
• Employee orientation process (newcomers' baseline knowledge a )
• Work atmosphere (hospital's presence on social media on organisational attractiveness considering work atmosphere)
• Relationships among colleagues
• Interdepartmental collaboration climate
• Opportunity to work with specialists
• Employee orientation process (discussions and interactions with colleagues, adapting responsibilities for tasks during orientation)
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Source: Authors' own work.

a

No statistically significant association with organisational attractiveness.

4.3.1. Patient‐Related Factors of Organisational Attractiveness

Patient‐related factors were identified as important for OA where quality of care was emphasised in some studies (Fréchette, Bourhis, and Stachura 2013; Slåtten, Lien, and Svenkerud 2019; Slåtten and Lien 2021). The quality of care was evaluated as the most essential factor in OA for graduating nursing students in Canada (Fréchette, Bourhis, and Stachura 2013). A Norwegian study found that the service quality of care, reflecting the performance of nurses as employees, was a statistically significant factor of OA for nurses working in public hospitals (Slåtten and Lien 2021). Another Norwegian study showed that employees' attitudes regarding attractiveness were related to employee service quality provision where exemplary service was delivered to patients (Slåtten, Lien, and Svenkerud 2019).

4.3.2. Work‐Related and Individual Factors of Organisational Attractiveness

The type of work (e.g., daily tasks, challenges, responsibilities, learning opportunities, opportunities to use acquired skills) was evaluated as a crucial factor of OA for graduating nursing students in Canada (Fréchette, Bourhis, and Stachura 2013). The association between a hospital's presence on Facebook and LinkedIn and OA according to employees and graduate nurses was explored in a Belgian study. There was a positive association between a Facebook presence and OA, but not between a LinkedIn presence and OA. The hospital's presence on both Facebook and LinkedIn correlated positively with the hospital's task diversity having an indirect effect on OA. Task diversity was defined as how the organisation offers a wide variety of tasks, an interesting range of jobs and challenging work. However, a statistically significant association between Facebook and LinkedIn presence on meaningfulness, which contributes to OA, was not found (Carpentier et al. 2017).

Graduating nursing students in Canada reported that the nurse‐to‐patient ratio was the most crucial factor for high quality of care to patients which contributes to OA (Fréchette, Bourhis, and Stachura 2013). The hospital's presence on LinkedIn demonstrated a positive association with work–life balance having an indirect effect on OA, whereas the presence of Facebook did not (Carpentier et al. 2017). Older age was the only individual factor with a statistically significant positive association with OA in a study conducted by Björn, Lindberg, and Rissen (2015). There was no statistically significant correlation between nurses' employment time and OA. Additionally, no correlations were found between work ability, general health and the intensity of neck or lower back pain, gender and OA (Björn, Lindberg, and Rissen 2015).

Status was found to be associated with OA according to Swedish nurses working in operating departments. Status meant having positive challenges, the opportunity to develop skills, being able to do a good job and feeling competent (Björn, Lindberg, and Rissen 2015). According to a Belgian study, both Facebook and LinkedIn presence had a positive relationship with advancement opportunities and competence according to nurses, having an indirect effect on OA (Carpentier et al. 2017). A Finnish study indicated a relationship between the employee orientation process and OA. The employee orientation process was valued throughout the hospital, and responsibilities for orientation were shared between the newcomer, team members and preceptors as well as managers and hospital administrators. However, the newcomers' baseline knowledge had only a weak correlation with OA (Peltokoski et al. 2015).

A positive work atmosphere was a crucial determinant of OA for nurses working in Polish hospitals (Buchelt et al. 2021). A Belgian study also demonstrated statistically significant associations between a hospital's presence on Facebook and LinkedIn with the hospital's work atmosphere which contributed to OA (Carpentier et al. 2017). Moreover, relationships among colleagues within the organisation were evaluated as notable determinants of OA for nurses (Björn, Lindberg, and Rissen 2015; Buchelt et al. 2021). There was also an association between interdepartmental collaboration climate and OA according to nurses working in public hospitals in Norway (Slåtten and Lien 2021). The opportunity to work with specialists was considered an important determinant of OA for Polish nurses (Buchelt et al. 2021). Discussions and interactions with colleagues were the most important variables of OA for newcomers in the orientation process. However, adapting responsibilities for tasks during orientation had only a weak correlation with OA (Peltokoski et al. 2015).

4.3.3. Organisational Factors of Organisational Attractiveness

Employer branding was considered an important factor of OA for graduating nursing students in a Canadian study (Fréchette, Bourhis, and Stachura 2013). A Belgian study investigated job‐seeking nurses' exposure to recruitment sources and their attraction to recruiting hospitals. The study revealed that especially word of mouth, but also recruitment advertising, recruitment events and publicity were strongly, positively related with the job seekers' attraction to organisations (Van Hoye 2012). Additionally, credibility was also positively associated with OA (Van Hoye 2012) which means the perceived truthfulness, trustworthiness and believability of the communicated information (Allen, Van Scotter, and Otondo 2004). According to a study that examined hospitals' presence on social media, both the presence of Facebook and LinkedIn predicted organisations' innovativeness having an indirect effect on OA. Moreover, a hospital's presence on Facebook was associated with the organisation's sincerity having an indirect effect on OA. In a study by Carpentier et al. (2017) an organisation's sincerity meant being honest, social and warm. However, a hospital's presence on LinkedIn was not associated with the organisation's sincerity. An association between a hospital's presence on Facebook and LinkedIn on prestige, which contributes to OA, was not found (Carpentier et al. 2017).

Nurses in Sweden evaluated that leadership is an important determinant of OA (Björn, Lindberg, and Rissen 2015). Norwegian nurses also evaluated that management support is an important factor of OA (Slåtten and Lien 2021). Another Norwegian study showed that an internal market‐oriented culture (IMOC) in the organisation was closely related to OA. IMOC captures employees' experiences, beliefs, and expectations regarding the degree to which managers care about them (Slåtten, Lien, and Svenkerud 2019).

Polish nurses evaluated that employment security (stability) was a statistically significant determinant of OA (Buchelt et al. 2021). According to a Belgian study the association between a hospital's presence on Facebook and LinkedIn on robustness, which contributes to OA, was not found (Carpentier et al. 2017). Nurses evaluated that compensation, such as regular payment of remuneration, is a crucial determinant of OA (Buchelt et al. 2021; Fréchette, Bourhis, and Stachura 2013). On the other hand, an association between a hospital's presence on Facebook and LinkedIn on the meaningfulness of payment, which contributes to OA, was not found (Carpentier et al. 2017).

Work engagement and OA shared a statistically significant positive correlation (Björn, Lindberg, and Rissen 2015; Slåtten, Lien, and Svenkerud 2019). There was also a positive association between OA and intention to stay among registered nurses in specialised hospital districts in Finland (Peltokoski et al. 2015). Additionally, OA has been found to be a key antecedent to lower turnover intentions for nurses employed in Norwegian hospitals (Slåtten, Lien, and Svenkerud 2019).

4.4. Integration of Qualitative and Quantitative Evidence

The integrated results indicated that patient and professional work well‐being, opportunities for professional growth and the responsibilities of the organisation are key themes that reflect nurses' perceptions of OA and related factors in health care (Tables 3 and 4 and Figure 2).

FIGURE 2.

FIGURE 2

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Organisational attractiveness and related factors based on the qualitative and quantitative evidence. Source: Authors' own work.

4.4.1. Patient and Professional Work Well‐Being

Two qualitative (De Groot, Maurits, and Francke 2018; Keisu 2017) and three quantitative (Fréchette, Bourhis, and Stachura 2013; Slåtten, Lien, and Svenkerud 2019; Slåtten and Lien 2021) studies reported the quality of care as an important factor of OA, with the nurse‐to‐patient ratio an important part of it (Fréchette, Bourhis, and Stachura 2013). The meaningfulness of work played an important role in OA in all qualitative studies (De Groot, Maurits, and Francke 2018; Keisu 2017; Prentice and Black 2007). The results of two qualitative studies reported that variety (De Groot, Maurits, and Francke 2018) and a balanced home‐life and work life (Prentice and Black 2007) were important features of OA, and a quantitative study showed that the hospital's presence on social media promoted these features (Carpentier et al. 2017). Older age was also related to OA, while gender was not (Björn, Lindberg, and Rissen 2015). Work satisfaction in terms of work engagement (Björn, Lindberg, and Rissen 2015; Slåtten, Lien, and Svenkerud 2019), the intention to stay (Peltokoski et al. 2015) and a lowered turnover rate (Slåtten, Lien, and Svenkerud 2019) had an association with OA. Five quantitative studies pointed out the significance of a collaborative working atmosphere in OA (Björn, Lindberg, and Rissen 2015; Buchelt et al. 2021; Carpentier et al. 2017; Peltokoski et al. 2015; Slåtten and Lien 2021) and this was complemented by one qualitative study (Prentice and Black 2007). The hospital's presence on social media was shown to promote more positive perceptions of the working atmosphere and sincerity in quantitative research (Carpentier et al. 2017), but it was not examined in qualitative studies.

4.4.2. Opportunities for Professional Growth

Two quantitative (Buchelt et al. 2021; Peltokoski et al. 2015) and two qualitative (Keisu 2017; Prentice and Black 2007) studies showed that professional development was a key factor in OA. In the quantitative studies, professional development was manifested by learning from colleagues (Buchelt et al. 2021; Peltokoski et al. 2015). In the qualitative studies, nurses evaluated that professional development increased OA through education (Keisu 2017; Prentice and Black 2007) and organisational strategies (Keisu 2017). A quantitative study complemented the results by demonstrating that a hospital's presence on social media promoted professional development, education, competence and innovativeness (Carpentier et al. 2017). One quantitative study (Björn, Lindberg, and Rissen 2015) included occupational status which was an important factor of OA. The finding was complemented by qualitative data on how the occupation was valued in the labour market and the workplace (Keisu 2017).

4.4.3. Responsibilities of the Organisation

Two quantitative studies considered brand as an important factor of OA (Fréchette, Bourhis, and Stachura 2013; Van Hoye 2012), but it was not investigated in any qualitative studies. Different recruitment sources were positively related to healthcare organisations' brands (Van Hoye 2012). Stability in the form of employment security (Buchelt et al. 2021) and compensation (Buchelt et al. 2021; Fréchette, Bourhis, and Stachura 2013; Keisu 2017) was represented in both qualitative and quantitative studies as an aspect of OA. Supervisory support was shown to have an impact on OA in terms of leadership (Björn, Lindberg, and Rissen 2015) and management support (Slåtten and Lien 2021) in quantitative studies, which was strengthened by qualitative studies (De Groot, Maurits, and Francke 2018; Keisu 2017). Additionally, an internal market‐oriented culture (IMOC) was found to be closely related to the perception of OA (Slåtten, Lien, and Svenkerud 2019). One qualitative study showed the importance of high‐level political decision‐making on OA (Keisu 2017). All qualitative studies considered that having autonomy is an important part of OA (De Groot, Maurits, and Francke 2018; Keisu 2017; Prentice and Black 2007), which was not considered in quantitative studies. The studies highlighted the meaning of both individual and team autonomy (De Groot, Maurits, and Francke 2018; Keisu 2017).

5. Discussion

To our knowledge, this is the first systematic review of nurses' perceptions of OA and related factors in health care. The integrated results indicated that patient and professional work well‐being, opportunities for professional growth and the responsibilities of the organisation are key themes of OA.

The first key theme, patient and professional work well‐being, highlighted the significance of the quality of care in OA (De Groot, Maurits, and Francke 2018; Fréchette, Bourhis, and Stachura 2013; Keisu 2017; Slåtten, Lien, and Svenkerud 2019; Slåtten and Lien 2021). This aligns with previous results that quality improvement efforts enhancing patient experience were considered crucial for achieving favourable outcomes (Dempsey and Assi 2018). Our results indicated that nurses find it attractive that the patient is the centre of care and there is a variety of patient situations and activities (De Groot, Maurits, and Francke 2018). According to a previous study by Bokhour et al. (2018), actions taken to foster patient‐centred care include staff engagement, innovations and alignment of staff roles and priorities. In addition, actions taken to foster patient‐centred care in a study by Bokhour et al. (2018) were leadership, patient and family engagement, organisational structures and the work environment.

Flexibility at work was found to be an important factor of OA for nurses according to our review (Prentice and Black 2007). Flexibility was also considered a work–life benefit in a previous study by Firfiray and Mayo (2017). Some previous studies have also highlighted the positive impact of flexible working practices on OA (Khan et al. 2023; Kröll, Nüesch, and Foege 2018), where organisational support is a key mediator (Kröll, Nüesch, and Foege 2018). According to previous studies, if organisations offer work–life benefits, they are more attractive to job seekers and more appealing than benefits or standard pay (Dassler et al. 2022; Firfiray and Mayo 2017). In other words, employees who perceive the organisation as employee‐focused, are attracted to it (Story, Castanheira, and Hartig 2016). In our review, a balanced home‐life and work life was a key factor related to OA (Prentice and Black 2007) which was also found to positively influence OA in a previous study by Carballo‐Penela (2019). However, in their study, Trybou et al. (2014) found that a work–life balance was not statistically significantly related to hospital attractiveness in a study concerning physicians.

Our results revealed that the type of work (Fréchette, Bourhis, and Stachura 2013) and meaningfulness of work (De Groot, Maurits, and Francke 2018; Keisu 2017; Prentice and Black 2007) play crucial roles in influencing OA. According to our results, nurses perceived that a pleasant working atmosphere is an important factor of OA (Buchelt et al. 2021), with a presence on social media promoting the work atmosphere (Carpentier et al. 2017). These results are in line with a previous systematic review by Dassler et al. (2022) which identified the work atmosphere, work environment, work itself and social media presence as antecedents of employer attractiveness. Moreover, our review indicated that relationships among nurses are notable related factors contributing to OA for nurses (Björn, Lindberg, and Rissen 2015; Buchelt et al. 2021). This aligns with a broader perspective provided by a review by McDaniel, Driebe, and Lanham (2013) highlighting that relationships in health care are important because they engender a positive work environment, enable important organisational behaviours and affect learning. Also, according to our results, work engagement was associated with OA in health care (Björn, Lindberg, and Rissen 2015; Slåtten, Lien, and Svenkerud 2019). Previous studies in the context of business and management (Dassler et al. 2022) and nursing (García‐Sierra, Fernández‐Castro, and Martínez‐Zaragoza 2016) also strengthen this finding by showing that OA increases work engagement.

The second key theme, opportunities for professional growth, showed the importance of professional development for OA (Buchelt et al. 2021; Keisu 2017; Peltokoski et al. 2015; Prentice and Black 2007). Professional development was classified as a work–life benefit in a previous study (Firfiray and Mayo 2017). Previous studies have also indicated that development opportunities serve as antecedents of OA (Carballo‐Penela 2019; Dassler et al. 2022; Story, Castanheira, and Hartig 2016; Trybou et al. 2014), emphasising the need to invest significant budgets for employee development (Dassler et al. 2022). Our review also revealed the impact of a hospital's presence on social media on professional development and innovativeness (Carpentier et al. 2017). Furthermore, in a prior study by Renaud, Morin, and Fray (2016), it was pointed out that innovative perks and training have a substantial impact on attractiveness among job applicants. Additionally, the hospital's use of social media was found to be positively related to their competitiveness (Al‐Nawafah et al. 2022).

The third key theme, the responsibilities of the organisations, indicated that the brand (Fréchette, Bourhis, and Stachura 2013; Van Hoye 2012) is related to OA. Previous results have also showed that the brand and the image of the company are strong predictors of applicant attraction (Dassler et al. 2022; Kalińska‐Kula and Staniec 2021; Story, Castanheira, and Hartig 2016; Uggerslev, Fassina, and Kraichy 2012; Wu and Dineen 2022). Individuals are attracted to organisations that match their individual characteristics, which can be capitalised by being mindful of the image presented during recruitment (Williams 2013). According to Yadav, Kumar, and Mishra (2020), branding is also positively related to work engagement.

Additionally, our results showed the importance of leadership (Björn, Lindberg, and Rissen 2015) and management support (Slåtten and Lien 2021) in influencing OA. These results were in line with previous results by Dassler et al. (2022) and Trybou et al. (2014) who found that top management leadership was positively correlated to OA. Our results also showed the importance of stability in the form of employment security (Buchelt et al. 2021) and compensation (Buchelt et al. 2021; Fréchette, Bourhis, and Stachura 2013; Keisu 2017) in OA in health care. The importance of pay and financial benefits were also confirmed as important predictors of OA in previous studies (Dassler et al. 2022; Trybou et al. 2014; Uggerslev, Fassina, and Kraichy 2012). However, in a study concerning physicians, stability was not found to be related to OA (Trybou et al. 2014).

5.1. Limitations

This systematic review has some limitations. It is possible that the search strategy did not identify all potential studies, despite the assistance of an experienced library information specialist. We only considered studies written in English, Finnish and Swedish, and there were no translation services available, which could lead to the exclusion of some relevant studies. Additionally, three full texts of possibly relevant studies were unavailable. Furthermore, the review only encompassed three qualitative studies, which may also affect the results. The quantitative studies received lower quality appraisal points than the qualitative studies, however, each at least 50%. Most of the point losses were due to confounding factors, as they were not clearly mentioned in several studies. Individual point losses were due to missing information. Potential inaccuracies in the extraction of data from primary studies could have led to a lack of synthesis of the results even though the data extraction was conducted by two reviewers. The studies were very heterogeneous which made it challenging to write narrative synthesis of data and draw meaningful conclusions.

6. Conclusions

The results indicated that patient and professional work well‐being has a considerable effect on OA. Organisations play a remarkable role in enabling nurses' professional growth, and the various dimensions of professional growth increase OA. Responsibilities of the organisation extend to higher political decision‐making as well as to senior and middle managers and immediate superiors of the healthcare organisations. Deepening the understanding of the concept of OA and related factors in healthcare context can help healthcare organisations understand the effects of OA better, and how OA can be enhanced. OA covers the entire organisation, its patients, professionals and managers. Enhancing multi‐professional cooperation, implementing effective management practices and branding of the organisation can contribute to increased OA.

7. Implications for Practice and Research

The results of our study provide some implications for practice and research in health care in terms of OA. Healthcare organisations are suggested to learn to identify and implement factors that affect the recruitment, attraction and retention of skilled nurses as well as the quality of care. Healthcare organisations are suggested to empower nurses with a high level of autonomy, especially in decision‐making and task execution. Developing strategies is crucial for improving nurses' competence, and organisations could provide training to support their professional development. Ensuring salary development in alignment with the demands of the work is of great worth. It is also important that the orientation of new employees extends to all levels of the organisation. Organisations are recommended to develop processes in which interdepartmental collaboration climate is improved.

Furthermore, offering nurses employment contracts that ensure security and stability based on the employees' individual needs is recommended. Additionally, by leveraging social media and developing their brand, organisations can increase OA. To improve OA, nurse managers are suggested to support nurses and take their wishes and needs into consideration when combining home‐life and work life. Nurse managers are also suggested to optimise the availability of the skilled workforce within resource constraints, thereby preventing nurses from experiencing excessive workloads.

It is necessary to carry out future research on OA, particularly qualitative studies. More diverse research across various healthcare organisations is needed, with a focus on better representation of nurses, and the views of various healthcare professionals. Furthermore, patient‐related and nurses' individual factors of OA should be examined more closely.

Author Contributions

Conception and design: K.K., M.M., S.K., and O.K. Acquisition of data: K.K. and M.M. Analysis and interpretation of data: K.K., M.M., S.K. and O.K. Drafting the manuscript: K.K., M.M., S.K. and O.K. Revising critically for important intellectual contents of the manuscript: K.K., M.M., S.K. and O.K. All authors have agreed on the final version.

Conflicts of Interest

The authors declare no conflicts of interest.

Peer Review

The peer review history for this article is available at https://www.webofscience.com/api/gateway/wos/peer‐review/10.1111/jan.16634.

Supporting information

Supporting Information S1. The preferred reporting items for systematic reviews and meta‐analyses: The PRISMA statement.

Supporting Information S2. Search strategies according to databases.

Supporting Information S3. Quality appraisal for qualitative studies using the JBI critical appraisal checklist for qualitative research.

Supporting Information S4. Quality appraisal for quantitative studies using the JBI critical appraisal checklist for analytical cross‐sectional studies.

JAN-81-1734-s001.zip (859.2KB, zip)

Acknowledgements

We would like to thank information specialist Kirsi Vähäkangas from the University Library of Oulu for helping us with the search strategy.

Funding: The authors received no specific funding for this work.

Karjalainen Kirsi and Makkonen Marjo contributed equally to this article.

Data Availability Statement

The data that supports the findings of this study are available in the Supplementary Information of this article.

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Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Supplementary Materials

Supporting Information S1. The preferred reporting items for systematic reviews and meta‐analyses: The PRISMA statement.

Supporting Information S2. Search strategies according to databases.

Supporting Information S3. Quality appraisal for qualitative studies using the JBI critical appraisal checklist for qualitative research.

Supporting Information S4. Quality appraisal for quantitative studies using the JBI critical appraisal checklist for analytical cross‐sectional studies.

JAN-81-1734-s001.zip (859.2KB, zip)

Data Availability Statement

The data that supports the findings of this study are available in the Supplementary Information of this article.

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