Journal of Modern Medical

Introduction
Human resources is the most important part of an organization. One of the important crises in health organizations is the shortage of nurses. The shortage of nurses and the high number of nurses leaving their professions is a concern in both developed and developing countries. The intention to leave or turnover intention is known as one of the barriers in the organizations to reach the goals. Considering the financial and human costs of leaving the job by nurses in health settings, it is very important to predict it before it happens to prevent them. Perceived organizational support is a social exchange between employees and the organization. When the employees perceive that the organization values their welfare, they also feel obliged to help the organization reach its goals. This study aims to determine the relationship between turnover intention and the perceived organizational support in nurses working in the hospitals in Gorgan, Iran.

Methods
This is a descriptive/analytical study with a cross-sectional design. The study population includs all nurses working in hospitals affiliated to Golestan University of Medical Sciences. Of these, 293 nurses were selected using stratified sampling method proportional to the population. Inclusion criteria were willingness to participate in the study and at least one year of work experience. The data collection tool was a three-part questionnaire including demographic/occupational form, Kim et al.’s turnover intention questionnaire (TIQ), and Eisenberger et al.’s perceived organizational support questionnaire (POSQ). The TIQ was developed by Kim et al. (2007) which has 15 items measuring the intention of employees to leave their work. Each question is rated on a five-point Likert scale from completely disagree to completely agree. The POSQ was developed by Eisenberger et al. (1986), which has 8 items rated on a five-point Likert scale from completely disagree to completely agree. The data was analyzed in SPSS software, version 23. Descriptive statistics were used to describe the data. Due to the abnormality of the data distribution (based on the Kolmogorov-Smirnov test results), the Mann-Whitney U test, Spearman’s correlation test, and Kruskal-Wallis test were used to analyze the data.

Results
The mean age of the participants was 33.93 ± 7.16 years and their mean work experience was 9.82 ± 6.32 years. Most of participants (82.6%) were female. Most of the nurses had a bachelor’s degree (91.5%), were married (77.5%), had permanent employment (51.9%), working in the emergency department (22.5%), and with rotating shift work (56%). The mean score of TIQ was 39.91 ±12.18, indicating that the turnover intention of nurses was at a moderate level. The mean score of the POSQ was 23.66 ±6.60, out of 40, indicating that the nurses’ perceived organizational support was at a moderate level. Turnover intention had a statistically significant relationship with gender (P=0.027) and educational level (P= 0.030). Perceived organizational support had a statistically significant relationship was with educational level (P=0.014). Spearman’s correlation test results showed that the turnover intention and the perceived organizational support in nurses had an negative and significant relationship with each other (P< 0.001); the increase in turnover intention  can reduce the perceived organizational support of the nurses.

Conclusion
The turnover intention  of nurses in Gorgan and their perceived organizational support are at a moderate level. With the decrease in perceived organizational support, their turnover intention  increases. Paying attention to salaries and benefits, and assuring nurses that they will not lose their jobs in case of any change in socio-economic conditions, can reduce the turnover intention  of nurses. Nursing managers should create a supporting environment for nurses, in such a way that the support be tangible and understandable to them, and provide them with job satisfaction.

Ethical Considerations
Compliance with ethical guidelines
This study was approved by the Research Ethics Committee of Golestan University of Medical Sciences (Code: IR.GOUMS.REC.1400.362).

Funding
This study was extracted from a research project and funded by Golestan University of Medical Sciences (Grant No.:112420).

Authors' contributions
Conceptualization: Alireza Heidari, Sakineh Beygom Kazemi; Methodology and data analysis: Zahra Khatirnamani; investigation: Mohammad Javad Kabir, Abbas Badakhshan; Data collection: Amene Kamal Gharibi, Abdi Kor; Data analysis: Mansoure Lotfi, Sajad Moeini; Writing: Alireza Heidari; Review and editing: All authors.

Conflicts of interest
The authors declare no conflicts of interests.

Acknowledgements
The authors would like to express their gratitude to the Vice-Chancellor for Research of Golestan University of Medical Sciences  and all the nurses participated in this study for their support and cooperation.


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