Identifying Intention-to-Stay Patterns: Latent Class Growth Analysis of RNs in Korean Nursing Homes

To identify distinct longitudinal trajectories of RNs' intention to stay in nursing homes (NHs) and examine key determinants to inform targeted workforce strategies.

A total of 163 RNs from 38 Korean NHs participated in a three-wave longitudinal survey (T1: August 2022; T2: May 2023; T3: February 2024). Latent class growth analysis identified three distinct trajectories: high-high (HH; consistently strong intention), high-low (HL; declining intention), and low-high (LH; improving intention). Individual- and organizational-level variables were measured.

Distinct intention-to-stay trajectories revealed significant differences in resilience and retention rates. The LH group exhibited the greatest improvement in resilience and intention to stay, whereas the HL group showed a decline in these variables. Organizational factors, such as higher RN retention rates, were positively associated with stronger intention to stay.

The current study underscores the importance of individual and organizational factors in shaping RNs' intention to stay in NHs. Strategies to enhance resilience and address systemic staffing challenges are essential for improving workforce stability and care quality. Findings provide actionable insights for policymakers and health care administrators in under-resourced NH environments, particularly in rapidly aging societies, such as South Korea.