What factors affect job embeddedness among

clinical nurses? A structural model design

Mi-Soon Yun
Woosong College
Miyoung Lee
Woosong University
Eun-Hi Choi (  imague0@naver.com )
Eulji University

Research Article

Keywords: Nurse, Role conflict, Positive psychological capital, Social support, Job crafting,
Embeddedness

Posted Date: July 14th, 2023

DOI: https://doi.org/10.21203/rs.3.rs-3132662/v1

License:   This work is licensed under a Creative Commons Attribution 4.0 International License.
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Abstract
Background
This study adopted a model-building research approach to analyze the factors affecting clinical nurses’
job embeddedness and explore the pathways to increase their embeddedness. The results are expected to
provide a basis for efficient human resource management in hospitals.

Methods
Participants were 260 clinical nurses with less than one year of experience in general and tertiary general
hospitals in G province and D metropolitan city in South Korea. A structured questionnaire was
administered from January 10 to February 28, 2022. The variables analyzed included role conflict,
positive psychological capital, social support, job crafting, and job embeddedness.

Results
The direct and total effects (both β = .806, p = .007) of positive psychological capital on job crafting were
significant. The direct and total effects (both β = .451, p = .004) of social support on job crafting were
significant. The direct (γ = .292, p = .055), indirect (γ = -. 671, p = .003), and total (γ = − .379, p = .008)
effects of role conflict on job crafting were significant. The direct (γ = − .382, p = .007), indirect (γ = − .208
p = .003), and total (γ = − .589, p = .006) effects of role conflict on job embeddedness were significant.
The direct and total (both β = .548, p = .005) effects of job crafting on job embeddedness were significant.

Conclusions
Nurses’ job embeddedness is directly influenced by their job crafting, which is shaped by high levels of
positive psychological capital and social support. When job crafting takes place, role conflict increases,
and if job crafting becomes difficult because of severe role conflict, job embeddedness decreases.
Therefore, to increase job embeddedness among clinical nurses, hospitals must implement support
systems and programs to increase job autonomy, positive psychological capital, and social support to
promote job crafting.

Background
Nurses, as the key human resources in hospitals, play the crucial role of providing close-contact nursing
care to patients [1]. As the nursing role is becoming professionalized, it is increasingly important not only
to have an adequate number of nurses but also to ensure the quality of those nurses [2]. However, nurses
have high turnover intention. According to the Hospital Nurses Association’s staffing status survey, nurses
had turnover rates of 15.4% in 2019 and 14.5% in 2021, with 17.1% citing “job inadequacy” as the reason
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for leaving [3]. The Korea Health and Medical Workers’ Union reported that 80% or more of nurses with 3‒
10 years of experience have considered leaving in the past 3 months [4].

Nurse turnover leads to a shortage of experienced nurses, which increases the workload of their
remaining co-workers, leading to job dissatisfaction and a vicious cycle of nurse turnover [5], which has a
negative impact on the safety of patients and organizational performance of the hospital [6]. Therefore,
recruiting and managing human resources has emerged as a challenge for hospitals to improve their
competitiveness and organizational efficiency, of which hiring adequate nursing staff and retaining
experienced nurses are important factors [7].

Substantial research has been conducted on reducing turnover intention among nurses, but the reasons
for leaving have proven difficult to identify [8]. Research has examined nurses’ retention intention, or their
intention to stay in their current jobs rather than seek other employment [9]. Recent studies have focused
on why nurses stay at their hospitals [10]. Against this backdrop, the concept of job embeddedness has
emerged as an influencing factor that keeps individuals at their places of work, going beyond the
intention to stay in an organization [11]. Embeddedness refers to the quality of being firmly and deeply
ingrained or fixed in place, and job embeddedness has developed as a concept to elucidate why
individuals stay with an organization even when they are not satisfied with their job or relationship with it
—that is, job embeddedness refers to the collection of forces that influence employee retention [12]. High
job embeddedness has a multidimensional impact on an individual’s intention to stay with the
organization, including improved organizational performance, motivation to perform, and job capabilities
[13]. Studies on job embeddedness have reported its correlations with role conflict [5, 10], and job crafting
[14].

Our study aimed to identify the influences that encourage nurses to remain rooted at their place of work—
beyond merely staying with the organization—by constructing a structural model of clinical nurses’ job
embeddedness based on the job crafting model of Wrzesniewski and Dutton [15] and then testing the fit
of the model (Fig. 1). Based on the hypothetical model, we established the following research
hypotheses:

Hypothesis 1

(H1). Job crafting has a positive effect on job embeddedness.

Job embeddedness and job crafting have been found to be related [14]. In organizations, it is important to
not only recruit talented workers but also ensure they can fulfil their potential [16]. Job crafting has begun
to attract attention as a concept of job-related behavior that enables the voluntary and positive
performance of one’s job and enhances internal motivation. Originally meaning “force,” “craft” is used in
the field of art to mean creating objects through skill and finesse. Job crafting can thus be defined as a
process of recreating one’s job, making it more meaningful [15]. The term job crafting assumes that
certain job characteristics and attributes motivate people to perform their jobs and that jobs can be
changed to become motivating [17]. Job crafting consists of three elements: task crafting, cognitive
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crafting, and relation crafting [15]. Task crafting refers to the change employees make to either the type or
the amount of work they do; cognitive crafting changes the purpose and meaning of work; and relation
crafting means building relationships with supervisors or co-workers, or improving them through
communication activities with people at work. Antecedents of job crafting include role conflict [5], positive
psychological capital [17, 18], and social support [19].

Hypothesis 2

(H2). Role conflict has a negative effect on job embeddedness.

Role conflict affects job embeddedness [14]. Hospitals are specialized and multidisciplinary workplaces
providing healthcare services to patients through collaborative efforts [20]. Nurses, who provide nursing
care, often experience role conflict owing to heavy workloads, unilateral orders and instructions, lack of
autonomy, and limited participation in decision-making [21]. When this role conflict is not addressed,
nurses’ turnover intention is likely to be higher, lowering retention intention [22] and increasing turnover
rates [23]. That is, role conflict influences job embeddedness.

Hypothesis 3

(H3). Social support has a positive effect on job crafting.

Social support affects job crafting [24]. It is defined as all the positive help that an individual receives
through their relationships with others [25] and is a collective term for the mental and physical resources
related to an individual’s work that they receive from family, supervisors, co-workers, and others [26].
Social support, as a positive resource that an individual can derive from family and co-workers [25, 27],
can reduce tension and promote stability by evoking positive emotions [28]. It thus has a positive impact
on job performance and reduces role conflict and the pressure on nurses’ adaptability, while also
decreasing their turnover intention [29].

Hypothesis 4

(H4). Positive psychological capital has a positive effect on job crafting.

Positive psychological capital has been studied as a variable to shed light on turnover [30] and
highlighted as a key factor of human resource management because it can maximize the potential of
individuals [31, 32]. Positive psychological capital refers to a complex, positive psychological state
wherein an individual is confident in the success of their performance, optimistic about the present and
future, and able to overcome obstacles [33]. Among nurses, positive psychological capital affects their
physical and psychological health by reducing negativity and increasing positivity [34], making nurses
more innovative and creative in their nursing practice. It also induces positive changes in hospitals by
affecting nurses’ job-related attitude and behavior [35].

Hypothesis 5

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(H5). Role conflict has a negative effect on positive psychological capital.

Hypothesis 6

(H6). Role conflict has a negative effect on social support.

Hypothesis 7

(H7). Role conflict has a negative effect on job crafting.

We aimed to present evidence that can serve as a basis for the efficient management of nursing
personnel, thereby contributing to enhancing nursing quality and improving patient safety. Specifically,
this study had the following three aims: first, construct a hypothetical model of the relations among role
conflict, positive psychological capital, social support, job crafting, and job embeddedness among clinical
nurses; second, test the hypothetical model of clinical nurses’ job embeddedness; and third, establish the
relations among role conflict, positive psychological capital, social support, job crafting, and job
embeddedness among clinical nurses.

Methods Research Model

We built a model of clinical nurses’ job embeddedness by establishing the paths between the variables
based on the job crafting model of Wrzesniewski and Dutton [15]. Motivational factors, as antecedents of
the job crafting model, were divided into job control needs, positive self-image, and relationships. We
constructed an integrated model including job embeddedness as an outcome of and factor in job
effectiveness (Fig. 1).

Participants
Participants were clinical nurses in general and tertiary general hospitals in G province and D
metropolitan city. Permission was sought from the directors of nursing at four general hospitals, and a
questionnaire explaining the purpose and methodology of the study was distributed to the heads of
nursing departments. Consenting nurses completed the questionnaire. Inclusion criteria for the study
were nurses who had worked in a general hospital for at least one year and consented to participate in
the survey. We excluded new nurses with less than one year of experience and nursing managers. Nurses
with less than one year of experience were excluded because they had not yet reached the point of off-
the-job education and training to be able to work independently, which may affect their job
embeddedness [36].

The criteria for the fulfilment of the structural equation were based on the maximum likelihood (ML)
estimation method, which recommends that a minimum sample size of 200‒400 is appropriate for
model validation [37]. Considering a 15% dropout rate, we distributed 300 copies of our questionnaire, of
which 290 were returned. We used 260 responses in the final analysis after excluding 40 responses that
were incomplete or showed an identical pattern in the item responses.
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Data Collection and Ethical Considerations
This study was approved by the Institutional Review Board of E University (EU21-081) and each
questionnaire was approved for use by the researcher. It was conducted from January 10 to February 28,
2022 after obtaining consent from the nursing departments of the study sites. We visited the nursing
departments of the hospitals and explained the purpose and content of the study to the department head;
after obtaining permission, we distributed questionnaires to each department through the nursing
department. We prepared a study manual that explained the purpose of the study, confidentiality
guarantee, and rights of the research participant. The explanation included assurances that the data
collected would be used for academic purposes only, that there would be no disadvantage as the data
would be anonymized, and that absolute confidentiality would be maintained. After reading this manual,
the participants voluntarily gave written consent to participate in the study and filled out the
questionnaire. Completing the questionnaire took about 15‒20 minutes. To ensure confidentiality, we
asked the participants to seal the questionnaires themselves. We collected the completed questionnaires
through the nursing departments. Those participants who completed the questionnaire were offered a
small compensation fee.

Tools
General Characteristics
The general characteristics segment of the questionnaire consisted of seven questions on sex, marital
status, age, hospital career, department, position in the organization, and type of duty.

Role Conflict
We used the scale proposed by Pareek [38], adapted by Kim [39], and modified and supplemented by Son
[40]. The instrument consists of 22 questions: four for role isolation conflicts, three for role expectation
conflicts, three for person–role conflicts, four for role ambiguity conflicts, two for inter-role conflicts, three
for role overload conflicts, and three for resource scarcity conflicts. Each question is scored on a Likert
scale ranging from 1 = Not at all to 5 = Strongly agree, with higher scores indicating higher role conflict.

After confirmatory factor analysis, the standardization coefficient should be at least .7 to indicate the
reliability of the individual observables [41]. In this study, after confirmatory factor analysis, two items
that hindered validity were removed, leaving 20 of the 22 items to be analyzed. In the study by Son [40],
the Cronbach’s α for reliability was .71 to .91. In our study, the Cronbach’s α was .89.

Positive Psychological Capital

We used the positive psychological capital questionnaire developed by Luthans [33] and modified and
supplemented by Yun [42]. The instrument consists of 24 items, including six items each for self-efficacy,
hope, resilience, and optimism. Each item is rated on a Likert scale ranging from 1 = Not at all to 5 =
Strongly agree, with higher scores indicating higher levels of positive psychological capital.

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After confirmatory factor analysis, we removed two items that hindered validity. In Yun’s study [42], self-
efficacy, hope, resilience, and optimism had Cronbach’s α values of .86, .86, .74, and .68, respectively. The
Cronbach’s α values in our study were .89, .84, .78, and .74 for self-efficacy, hope, resilience, and
optimism, respectively. The overall Cronbach’s α was .89.

Social Support
We used the instrument developed by House and Wells [43] and modified and supplemented by Jung [44].
The instrument consists of 24 questions: eight questions each on support from supervisors, support from
co-workers, and support from family and friends. Each question is rated on a Likert scale ranging from 1
= Not at all to 5 = Strongly agree, with higher scores indicating higher social support. In our study, the
Cronbach’s α was .93, similar to that in Jung’s study [44].

Job Crafting
We used the tool developed by Slemp and Vella-Brodrick [45] and adapted to the Korean setting by Lim et
al. [46]. The instrument consists of 15 questions: five questions each for task crafting, cognitive crafting,
and relation crafting. Each item is rated on a Likert scale ranging from 1 = Not at all to 6 = Strongly agree.
Instrument reliability was Cronbach’s α = .91 in the original study [45] and Cronbach’s α = .87 in our study.

Job Embeddedness
We used the tool developed by Mitchell et al. [11] and modified and supplemented by Kim et al. [47]. The
instrument consists of 18 questions: eight on fit, four on links, and six on sacrifice. Each item is rated on
a Likert scale ranging from 1 = Not at all to 5 = Strongly agree, with higher scores indicating higher job
embeddedness. Confirmatory factor analysis showed that one item ‘links’ hindered validity; we removed
this item. The Cronbach’s α was .87 in the study by Kim [47] and .88 in our study.
Data Analysis Method
The collected data were analyzed using SPSS 26.0 and AMOS 26.0. We analyzed the general
characteristics of the participants and study variables using descriptive statistics. Skewness and kurtosis
were examined to verify the normality of the structural equation. Since structural equations are an
extension of regression, we checked for multicollinearity before implementing the structural model.

To assess how well the hypothetical model is supported by the data collected, we tested the goodness of
fit of the model using ML estimation. To assess the goodness of fit of the structural model, we analyzed
the data using the absolute fit index, χ2(CMIN), χ2/df, standardized root mean square residual (SRMR),
root mean square error of approximation (RMSEA), goodness of fit index (GFI), adjusted goodness of fit
(AGFI), and comparative fit index (CFI).

We checked the internal consistency of the measures for the latent variables using the average variance
extracted (AVE) and construct reliability (CR) values. Discriminant validity refers to the degree of
difference between the latent variables and requires low correlation between the measures obtained when
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measuring a concept. We determined discriminant validity by comparing the respective AVE values
between the constructs with the squared correlation coefficient between them [48].

We used modification indices to determine the final model. We selected theoretically relevant models
from the order of the largest modification indices and modified the connected models in turn. To test the
research hypotheses, we assessed the statistical significance of the indirect and total effects of the
model using the bootstrapping method.

Results
General Characteristics of the Participants
The total number of participants in this study was 260, with 90.8% women and 9.2% men; by marital
status, 83.5% were single. The mean age of the participants was 28.99 ± 4.86 years, with 51.5% aged 25–
29 years. Under one-third had clinical experience of 3 years or less (30.8%) and 30.0% had clinical
experience of 5–10 years.

The breakdown by department was as follows: 45.0% general ward, 24.2% intensive care unit, and 12.3%
emergency department. The vast majority of the participants were general nurses (91.5%) and 8.5% were
charge nurses. In terms of working hours, 88.1% were shift workers and 8.1% were full-time workers.
Table 1 shows the general characteristics of the participants.

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 Table 1
General Characteristics of the Participants (N = 260).
Characteristic Category N % M ± SD

Sex Male 24 9.2

Female 236 90.8

Marital status Single 217 83.5

Married 43 16.5

Age (years) ≤ 24 33 12.7 28.99 ± 4.86

25–29 134 51.5

30–34 67 25.8

≥ 35 26 10.0

Hospital career (years) ≤2 80 30.8 5.38 ± 4.76

3–4 68 26.1

5–9 78 30.0

≥ 10 34 13.1

Department General ward 117 45.0

ICU 63 24.2

OR 10 3.9

OBGY/ped 20 7.7

ER 32 12.3

OPD 18 6.9

Position Nurse 238 91.5

Charge nurse 22 8.5

Type of duty Three-shift duty 228 87.7

D/E fixed 6 2.3

Regular work 22 8.5

Other 4 1.5

Note: SD = Standard Deviation; ICU = Intensive Care Unit; OR = Operation Room; OBGY = Obstetric
Gynecology; Ped = Pediatrics; ER = Emergency Room; OPD = Outpatient Department; D/E = Day or
Evening.

Descriptive Statistics and Normality Checks

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To determine whether the data met the assumption of normality, we measured the skewness and kurtosis
of the measured variables and found that their absolute values did not exceed 2. Hence, they all met the
assumption of normality. The confirmatory factor analysis of the variables showed that the AVE was
more than .7 and CR was more than .9, confirming convergent validity. An AVE of .5 or higher and CR of .7
or higher are considered to indicate meaningful convergent validity [48].

To verify discriminant validity, we checked the correlations among the variables. The highest correlation
was between positive psychological capital and job embeddedness (.776, square of .602). The AVE of
positive psychological capital was .756 and that of job embeddedness was .701, both greater than the
squared value of the correlation coefficient, indicating discriminant validity. Table 2 shows the descriptive
statistics and normality checks for the metrics.

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 Table 2
Descriptive statistics and normality checks (N = 260).
Variable Mean SD Skewness Kurtosis AVE CR

Role conflict 2.57 .51 − .17 − .23 .732 .997

Role isolation 2.12 .53 .26 .17

Role expectation 2.40 .81 .25 − .42

Person–role 2.68 .79 .17 − .51

Role ambiguity 1.71 .63 .67 .63

Inter-role 2.63 .91 .10 − .64

Role overload 3.02 .86 − .18 − .24

Resource scarcity 3.35 .85 − .36 − .10

Positive psychological capital 3.19 .50 − .03 1.11 .756 .996

Self-efficacy 2.83 .73 .14 .34

Hope 3.52 .58 .29 1.34

Optimism 3.13 .64 − .15 .00

Resilience 3.29 .62 − .13 .42

Social support 3.73 .55 .00 − .04 .736 .997

Support from supervisors 3.57 .70 − .40 .43

Support from co-workers 3.90 .58 − .30 .27

Support from family and friends 3.74 .72 − .26 − .02

Job crafting 3.95 .68 − .25 .10 .724 .992

Task crafting 3.90 .75 − .19 .11

Cognitive crafting 3.97 .94 − .28 − .21

Relation crafting 3.97 .77 − .09 .59

Job embeddedness 3.07 .50 .60 .84 .701 .994

Fit 3.30 .62 − .38 .75

Sacrifice 2.36 .63 − .09 − .19

Note: SD = Standard Deviation; AVE = Average Variance Extracted; CR = Construct Reliability.

Hypothetical Model and Modification

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In this study, all the correlation coefficients among the measured variables were less than .7 compared
with a recommended threshold of .5, while the variance inflation factors were less than 1.8, meaning no
problem with multicollinearity. We tested the goodness of fit of the model using ML estimation to assess
how well the hypothetical model of job embeddedness is supported by the data collected. The model fit
was 2.889 for CMIN/df, .868 for GFI, .822 for AGFI, .879 for CFI, and .085 for RMSEA. The model was
modified by selecting the theoretically relevant models with the largest modification indices to improve
the model fit and then connecting them to determine the final modified model. The final model had a
CMIN/df of 2.617, GFI of .884, AGFI of .840, CFI of .899, and RMSEA of .079, showing that the fit had
improved (Table 3).

Table 3
Goodness of fit of the model and modified model.
Model CMIN CMIN/df GFI AGFI CFI SRMR RMSEA

χ2 df p

Reference > .05 ≤3 ≥ .9 ≥ .8 ≥ .9 ≤ .08 ≤ .10

Hypothetical 326.448111 113 < .001 2.889 .868 .822 .879 .089 .085
model

Modified 290.442111 111 < .001 2.617 .884 .840 .899 .076 .079
model

Note: GFI = Goodness of Fit Index; AGFI = Adjusted Goodness of Fit Index; CFI = Comparative Fit Index;
SRMR = Standardized Root Mean Square Residual; RMSEA = Root Mean Square Error of
Approximation

Pathways of the Model

The effect of role conflict on positive psychological capital (γ = − .584, p < .001) was statistically
significant, with an explanatory power of 21.1%. The effect of role conflict on social support (γ = − .891, p
< .001) was statistically significant, with an explanatory power of 44.5%. Job crafting was statistically
significantly affected by role conflict (γ = .430, p = .009), positive psychological capital (β = .933, p < .001),
and social support (β = .496 p < .001), with an explanatory power of 76.9%. Job embeddedness was
statistically significantly affected by role conflict (γ = − .624, p < .001) and job crafting (β = .609, p < .001),
with an explanatory power of 60.4%. The paths of the modified model are shown in Table 4 and Fig. 2.

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 Table 4
Pathways of the models.
Endogenous variables RW SRW SE CR p SMC
← Exogenous Variables

Positive psychological capital

← Role conflict − .584 − .460 .111 -5.276 < .001 .211

Social support .445

← Role conflict − .891 − .667 .127 -7.011 < .001

Job crafting

← Role conflict .430 .228 .165 2.610 .009 .769

← Positive psychological capital .933 .806 .121 7.705 < .001

← Social support .496 .431 .112 4.421

Job embeddedness

← Role conflict − .624 − .382 .112 -5.556 < .001 .604

← Job crafting .609 .548 .078 7.829 < .001

Note: RW = Regression Weight; SRW = Standardized Regression Weight; SE = Standard Error; CR =

Critical Ratio, SMC = Squared Multiple Correlations

Verification of the Research Hypotheses

To test the research hypotheses, we analyzed the direct, indirect, and total effects among the latent
variables. The bootstrapping method was used to verify the statistical significance of these effects
(Table 5).

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 Table 5
Direct, indirect, and total effects of the modified model.
Endogenous variables Standardized Standardized Standardized total
effects(p)
← Exogenous variables direct indirect
effects(p) effects(p)

Positive psychological capital

← Role conflict − .460(.005) − .460(.005)

Social support

← Role conflict − .667(.006 − .667(.006)

Job crafting

← Role conflict .292(.055) − .671(.003) − .379(.008)

← Positive psychological .806(.007) .806(.007)

capital

← Social support .451(.004) .451(.004)

Job embeddedness

← Role conflict − .382(.007) − .208(.003) − .589(.006)

← Job crafting .548(.005) .548(.005)

← Positive psychological .441(.005) .441(.005)

capital

← Social support .247(.003) .247(.003)

The direct (γ = − .460, p = .005) and total (γ = − .460, p = .005) effects of role conflict on positive
psychological capital were significant. Similarly, the direct (γ = − .667, p = .006) and total (γ = − .667, p
= .006) effects of role conflict on social support were significant. Therefore, H5 and H6 were supported.
Meanwhile, the direct (γ = .292, p = .055), indirect (γ = − .671, p = .003), and total (γ = − .379, p = .008)
effects of role conflict on job crafting were significant. Therefore, H7 was rejected.

The results also showed support for H1 to H4. The direct (β = .806, p = .007) and total (β = .806, p = .007)
effects of positive psychological capital on job crafting were significant. The direct (β = .451, p = .004)
and total (β = .451, p = .004) effects of social support on job crafting were significant. The direct (γ =
− .382, p = .007), indirect (γ = − .208 p = .003), and total (γ = − .589, p = .006) effects of role conflict on job
embeddedness were significant. Lastly, the direct (β = .548, p = .005) and total (β = .548, p = .005) effects
of job crafting on job embeddedness were significant.

Discussion

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We built a structural model of clinical nurses’ job embeddedness based on a literature review, particularly
the job crafting model of Wrzesniewski and Dutton [15]. We then used the model to verify the significance
of role conflict, positive psychological capital, social support, and job embeddedness after testing the fit
of the model using the collected data.

This study found that job crafting and role conflict directly affected job embeddedness, with job crafting
having the strongest effect. These findings are supported by a previous study that showed a correlation
between job crafting and job embeddedness [14]. Higher job crafting relates to higher job embeddedness,
which directly affects job effectiveness [15]. This is because job crafting affects the organization by
employees changing the methods or boundaries of the job [15], thereby increasing the meaning of and
satisfaction with work by changing its scope based on changes in nursing behavior and work perception
[49]. Tims and Bakker [50] argued that job crafting is more active when autonomy or task independence
is highly guaranteed. That is, organizational members must have job autonomy to be more actively
involved in job crafting, which leads them to assign meaning to their jobs and set their own goals [51]. In
addition, job crafting is increased through motivation and positive interactions with co-workers [50, 52].
Therefore, increased job embeddedness is promoted by job crafting, for which it is crucial to increase job
autonomy, meaningful work, and positive interactions with co-workers. By experiencing this process,
nurses become embedded in the organization.

The present study found that social support had a direct effect on job crafting and an indirect effect on
job embeddedness. These findings are consistent with previous research showing that social support is
related to job crafting [24] and also affects job embeddedness [53]. Relation crafting increases
collaborations and interactions with superiors and colleagues from other departments through active
exchanges [54]. As nursing is a team-oriented profession, support from co-workers can reduce emotional
tension in tense situations [55], which in turn affects job crafting. Moreover, support from superiors—as
feedback, shared information, or counseling on organizational life—has a huge impact on employees [56].
When supervisors understand and acknowledge employees’ perspectives, employees are provided with
possible options [57], motivated to do their jobs, and more effective. Thus, job crafting involves not only
actively engaging in work but also building and improving relationships [58].

This study found that positive psychological capital had direct and indirect effects on job embeddedness,
consistent with the findings of previous studies [17, 59]. As positive psychological capital influences
employees’ positivity toward their work and the organization [60], individuals with a highly positive
mentality tend to work actively toward achieving their goals and take the initiative in designing their work
[61]. They try to overcome difficulties patiently by using accessible resources based on their optimistic
perspective of a situation [33]. The effect of positive psychological capital on job embeddedness was
indirect via job crafting. Even when challenging situations arise in nursing, positive thinking can improve
job performance, leading to higher job satisfaction [62], which results in greater engagement at work and
ultimately a greater intention to stay with the organization [63, 64]. High positive psychological capital is
a crucial factor in job embeddedness and is associated with nurses’ performance at work and therefore
their successful achievement of organizational goals [65].
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Meanwhile, role conflict had a direct negative effect on job embeddedness. Although research confirming
the relation between role conflict and job embeddedness in clinical nurses is lacking, a study on nurses
working in nursing homes reported that role conflict has a negative effect on job embeddedness [66],
supporting the findings of our study. Nurses face conflicts when they interact with various people, which
is an unavoidable part of providing nursing care [67]. Given that high role conflict is associated with
increased negative emotions, low self-esteem [68], and low organizational commitment, which raise
turnover intention [69], organizations should seek to moderate the role conflict of employees to increase
their job embeddedness.

Role conflict directly positively affected job crafting and negatively affected job embeddedness. Pareek
[38] categorized the types of role conflicts as role isolation conflicts, role expectation conflicts, person–
role conflicts, role ambiguity conflicts, etc suggesting that various factors cause role conflicts. Role
conflict and job crafting have several positive impacts. Role conflict occurs under conditions of low
autonomy to change one’s scope of work, which leads to an increase in job crafting to create a new job
from a given job [52]. Some types of role conflicts may also arise in the process of taking the initiative
and being creative. When role conflict is not resolved, job embeddedness is reduced. However, the causal
relation between role conflict and job crafting could not be confirmed in our cross-sectional study with
unknown time points. Future research could thus study the effect of role conflict on job crafting more in
depth to bridge this research gap.

Indeed, our study has a number of limitations that should be acknowledged. First, since this is a cross-
sectional study aiming to build a model of job embeddedness based on the theory, temporal causality
could not be confirmed. Second, this study is limited to general and tertiary general hospitals. Given the
various types of hospitals, it may be difficult to extend the findings to all hospitals. Nevertheless, this
study is significant, as it provides a basis for nursing research on job embeddedness despite the lack of
studies on the antecedents of job embeddedness, by building a hypothetical model of job embeddedness
among clinical nurses and identifying the influencing factors.

Conclusions
This study used a model-building research approach to analyze the factors affecting clinical nurses’ job
embeddedness and explored the pathways to increase their embeddedness, thereby providing a basis for
efficient human resource management. Job crafting affects job embeddedness when positive
psychological capital and social support are high. When job crafting takes place, role conflict increases,
and if job crafting becomes difficult because of severe role conflict, job embeddedness decreases. Hence,
role conflict and job crafting directly explain over 60% of the job embeddedness of clinical nurses.

To increase the job embeddedness of nurses, hospitals need to enhance nurses’ job autonomy. Nurses
also need organizational support to enhance positive psychological capital and social support. This
should be followed by enhanced training and programs to strengthen them. All these can ultimately
contribute to efficient human resource management in hospitals.

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Declarations
Authors’ Contributions

Study conception and design: MSY & ML; Data collection, data analysis, and interpretation: MSY & EHC;
Drafting of the article: MSY & EHC; Critical revision of the article: EHC; All authors read and approved the
final manuscript.

Ethics approval and consent to participate

Ethics approval and consent to participate: This study was approved by the Institutional Review Board of
Eulji University (EU21-081) before data collection. The participants were provided with an information
sheet and consent form specifying the anonymous nature of the survey and their freedom to withdraw
from the study at any time. In this study, informed consent was obtained from all subjects to participate
in the study and all methods were carried out in accordance with relevant guidelines and regulations.

Consent for publication: Not applicable

Data Availability: Data available upon request by email to the corresponding author.

Conflicts of Interest: Not applicable

Funding Statement: This research received no specific grant from any funding agency in the public,
commercial, or not-for-profit sectors. The authors declare that there are no conflicts of interest.

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Figures

Figure 1

Conceptual framework of our study.

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Figure 2

Path diagram of the modified model.

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