Samenvatting

Background
Dropout in later years of the nursing degree programme involves lost investment and is a particular problem for both students and educators. Reasons for late dropout seem to be related to the work and learning environment of the clinical placement.

Objectives
The aim of this study was to investigate associations between psychosocial work characteristics and distress and intention to leave nursing education among third-year nursing students.

Design
A prospective cohort study.

Setting
A Bachelor of Nursing programme of a University of Applied Sciences in the Netherlands.

Participants
363 third-year nursing students.

Methods
Baseline and one-year follow-up measurements were used from a prospective cohort study. Third-year nursing students were invited annually in May between 2016 and 2018. Psychosocial work characteristics were psychological demands, supervisor and co-worker support, and acts of offensive behaviour. Logistic regression analyses were used to build multivariate models.

Results
Frequent exposure to violence (OR = 2.52, 95% CI: 1.29–4.92) was univariately associated with distress. In the multivariate model for distress, psychological demands (OR = 1.63, 95% CI: 1.05–2.52) and frequent exposure to violence (OR = 3.02, 95% CI: 1.48–6.19) were associated with distress. Supervisor support (OR = 0.54, 95% CI: 0.36–0.80) and co-worker support (OR = 0.41, 95% CI: 0.24–0.72) were negatively associated with intention to leave (i.e. were protective) in the univariate model. In the adjusted multivariate model, only co-worker support (OR = 0.50, 95% CI: 0.25–0.97) was a protective factor for an intention to leave.

Conclusion
Psychological demands and frequent exposure to violence are risk factors for distress, and co-worker support is a protective factor reducing the intention to leave nursing education in the last stage of the programme. Improving the psychosocial working climate of nursing students may reduce the intention to leave at a late stage in nursing education, and hence actual late dropout.