Development of a Retention Model for Nursing and Medical Staff in the Healthcare Sector with a Quality of Work Life Enhancement Approach

Hassan Reza Anbarloo; Nabiollah  Mohammadi; Homa  Doroudi; Arshad  Farahmandian

Authors

Hassan Reza Anbarloo Ph.D. Student, Department of Management, Za.C., Islamic Azad University.Zanjan, Iran Author https://orcid.org/0009-0004-4309-290X
Nabiollah Mohammadi Department of Management, Za.C., Islamic Azad University.Zanjan, Iran https://orcid.org/0000-0002-0556-4951
Homa Doroudi Department of Management, Za.C., Islamic Azad University.Zanjan, Iran Author https://orcid.org/0000-0003-1635-7330
Arshad Farahmandian Department of Management, Za.C., Islamic Azad University.Zanjan, Iran Author https://orcid.org/0000-0002-2559-834X

Keywords:

Retention, Nursing and Medical Staff, Quality of Work Life, Fuzzy Delphi, Structural Equation Modeling (PLS-SEM), Fuzzy DEMATEL

Abstract

To develop an expert-informed model of nursing and medical staff retention that incorporates quality-of-work-life considerations. This applied, cross-sectional study used a fuzzy multi-criteria decision-making framework. A panel of 23 purposively selected experts assessed the proposed factors through fuzzy Delphi rounds. A subgroup of five experts provided pairwise judgments for fuzzy DEMATEL analysis, followed by DEMATEL-based analytic network process (DANP) weighting. Content validity was assessed using the content validity ratio (CVR) and content validity index (CVI). The proposed framework comprises five dimensions, 12 components and 42 indicators. In the reported DEMATEL results, the organizational (D−R = 0.53), technological/process-related (0.31), and psychological (0.28) dimensions were classified as net influencing factors, whereas the work environment (−0.89) and individual (−0.28) dimensions were classified as net influenced factors. These classifications represent expert-assessed influence relationships rather than experimentally demonstrated causation. Organizational arrangements and process improvement emerged as priorities within the expert-derived influence network. Practical retention strategies should also address clinical working conditions, workload, professional development and psychological support. Further empirical validation is required before the model can be interpreted as predictive of observed staff retention.

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