Nursing Retention in South Africa
2nd Paper – Quantitative Research
Title
Mokoka,K.E., Ehlers, V.J. & Oosthuizen, M.J. (2011). Factors influencing the retention of registered nurses in the Gauteng Province of South Africa. Curationis, 34(1), 9. Retrieved from http://dx.doi. org/10.4102/curationis. v34i1.16
Introduction
South African Nursing Council has predicted a critical nursing staff shortage within the country in the near future. This phenomena occurred as the number of nurse graduates has reduced by 42% over a period of 10 years. The authors carried out this exploratory descriptive quantitative study with the intention to investigate work related factors that influence nurses decision to stay with current employer. Questionnaires were posted to 536 registered nurses selected using random sampling method. Authors employed postal questionnaires as data collection instrument to targeted respondents with covering letters and stamped addressed return envelope. However, only 108 questionnaires returned where 73.1% of responded nurses expressed thoughts of leaving their job. Data analysis of this study employed quantitative descriptive procedures using Statistical Package for the Social Sciences (SPSS) tool. As a result, financial factors was the most important factor influencing nurses’ retention. Recommendations based on the results of this study made to the employers for implementation to reduce turnover and enhance retention. Data collection method will be discussed in this study.
Data collection method
Structured self report survey-based method was used by the authors in the data collection. Researchers have the options of face to face interview, phone interview, postal questionnaires and online (electronic) questionnaires.
Since this cross sectional quantitative survey consisted of large number of sample to achieve generalization of the study, postal questionnaires as data collection instrument is favored (Stenhammar et al., 2011). In addition to that, Ashby et al. (2010) reported that postal questionnaires tool is frequently used for health services research. In fact, postal questionnaires approach used by researchers can be distributed throughout a wider geographic area thus increases the number of return samples. McDonald and Adam (2003) claimed that postal data collection received twice response rate than online method. Similarly, Shih and Fan (2007) reported that postal mail survey gives better response rate as compare to electronic mail after a review into 35 studies. Subsequently, high questionnaires response rate will ensure study’s validity and avoid bias (Stenhammar et al., 2011). However, postal survey with incomplete questionnaires is excluded hence the occurrence of item-missing data reduces data quality. Meanwhile, force function set up to ensure completion of questionnaire for online data is not possible for postal data. Indeed, Basi (1999) found that completion of data by online respondent is more than that of postal respondent. On the contrary, Stanton (1998) compared postal and online questionnaires and suggested that there were no differences in the item variability and amount of incomplete data. Even so, there were variety of findings in the studies that compare the postal and online methods (e.g. Buchanan,2003; Epstein et al., 2001; Lewis et al., 2009).
As many researchers begin to recognize the impending trend where network interactions progressively gain popularity among the population, it is highly possible that electronic devices will play an active role in time. According to McDonald and Adam (2003), online technologies might include interactive television, handphones and 3D simulations touch screen devices. However in 1999, Dommeyer and Moriarty concluded that online data collection methods do not result in higher response levels and Cobanoglu et al. (2001) stated that postal survey was a common research method in year 2000. When exploring the social background of the participants, mail response samples showed conventional and introvert profiles. Whereas, the online response samples showed profile of technology savvy group (Schillewaert & Meulemeester, 2005). Clearly, penetration of technologies and adaptation of users are other important factors to consider by researchers while referring to the social-demographics pattern of the population.
There were total of 89 questions in this study that may reduce the response rate significantly. Given the circumstances that nurses in the sample group have been busy at workplace and back home (handling household chore), they are less likely to participate in the study actively. In this case, question designs by researchers must be focused and short to extract required information and encourage participation. As pointed out in a pilot study carried out by Jepson et al. (2004) the threshold for questionnaire length on a favorable response rate was approximately 1000 words. In addition, Edwards et al. (2003) supported this hypothesis after the review of 251 relevant reports concluding that using shorter questionnaire increases response rate. In another word, questionnaire design is important to speed up returns. All things considered, novice researchers consider the use of questionnaires are advised to refer experts and literature on the similar study ( Drummond et al., 2007; Dunn et al., 2002; Marshall, 2004 ).
Then again, traditional research method such as postal survey costs more as compared to online survey. Postal cost includes those of printing, preparing mail cover and two way postage (MacDonald & Adam, 2003; Mehta & Sivadas, 1995; Weibie & Wallace, 1998). Moreover, to improve postal questionnaire response rates few measures were introduced for examples including pencils and erasers in the postage package, sending reminder in the form of text messages or electronic mail. For the study on cost effectiveness of including pencils and erasers, Aveyard et al. (2001) found that there was no benefit shown to set off the cost. Nevertheless, text messages as suggested can be conveniently implemented as a strategy to increase response rate by researchers because participants take shorter time to access text messages on phone than electronic mail ( Keding et al., 2016; Man et al., 2010).
Conclusion
Selection of data collection instrument is essential to enhance survey quality while taking into consideration the aspect of accuracy, cost and timeliness. Unfortunately, studies looking at comparative result among different data collection methods over the years has produced conflicting outcome (Weigold et al., 2013). In time, health care providers being the technologically sophisticated population may be able to provide higher response rate in web-based survey with the improvement of internet accessibility and successful technology adoption (Weible & Wallace, 1998). On the whole, ongoing study is required to monitor the evolution of health care research so that the researchers can decide on the suitable method for their studies.