http://e-journal.unair.ac.id/JNERS | 301 Jurnal Ners Vol. 14, No. 3, Special Issue 2019 http://dx.doi.org/10.20473/jn.v14i3(si).17151 This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License Systematic Review The Impact of Perceived Organizational Support (POS) for Increasing the Intention to Stay: A Systematic Review Mira Melynda Prakosa, Nisa Dewanti and Sena Wahyu Purwanza Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia ABSTRACT Background: Nurse turnover is a problem that occurs in hospitals. The high turnover of nurses in health facilities can have a negative impact on the needs of the patients and on the quality of the health services. The turnover of nurses thus becomes a serious challenge to the efficiency, effectiveness and productivity of the health services. The aim of the systematic review was conducted to examine the impact of perceived organization support when it came to increasing the intention to stay. Method: A systematic search was conducted using articles from Scopus, Science Direct and SAGE. The search identified 15 original articles and full texts published between 2014 and 2019. Result: Nurses with high perceived organizational support with their organization have a lower intention to leave the organization. POS is the key predictor of turnover intention. Conclusion: POS can reduce turnover, especially for nurses. The positive perception of the organization can decrease turnover intention. POS that is felt strongly will affect the work performance of the nurses by increasing their intention to stay. This can the reduce hospital costs when it comes to having to recruitment new nurses. ARTICLE HISTORY Received: Dec 26, 2019 Accepted: Dec 31, 2019 KEYWORDS perceived organization support; turnover intention; intention to stay; intention to leave CONTACT Mira Melynda Prakosa  mira.melynda.prakosa- 2018@fkp.unair.ac.id  Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia Cite this as: Prakosa, M. M, Dewanti, N & Purwanza, S. W. (2019). The Impact of Perceived Organizational Support (POS) for Increasing the Intention to Stay: A Systematic Review. Jurnal Ners, 14(3si), 301-.304 doi:http://dx.doi.org/10.20473/jn.v14i3(si).17151 INTRODUCTION Nurse turnover is a problem that occurs in hospitals. The turnover percentage of nurse is greater than in any other profession. The turnover of nurses became a serious challenge regarding the efficiency, effectiveness, and productivity of the health services. Healthcare organizations need to keep the turnover rate among nurses low to maintain the quality of the nursing services that they provide (Bobbio & Manganelli, 2015). High turnover for the nurses in health facilities can have a negative impact on the needs of the patients and on the quality of the health services. The direct impact can be seen in the extra cost incurred i.e. personnel, recruitment, selection, and training costs (Kalidass & Bahron, 2015). Nurse turnover complicates the human resources when it comes to sustaining or building a quality team of staff and this often leads to high costs for recruiting and training new nurses. Nurse turnover also resulted in losses in the organization (Yim, Seo, Cho, & Kim, 2017). Thus, we expect that perceived organizational support acts as a relationship mediator between turnover intention and organizational commitment, as well as for this relationship to be stronger when the employees perceive there to be high organizational support compared to when they perceive there to be low organizational support. Perceived organizational support may be defined as the worker’s belief of the organization’s consideration regarding his/ her contributions, and the extent to which the organization is concerned about the worker’s well- being (Bohle, 2016). Based on where the employees’ expectations are not met by the organization, we propose the betrayal perspective to understand the influence of perceived organizational support on the relationship between job insecurity and affective organizational commitment (Fernet, Trépanier, Demers, & Austin, 2017). This concept has also been viewed as a relevant issue for perceived organization https://creativecommons.org/licenses/by/4.0/ https://creativecommons.org/licenses/by/4.0/ mailto:mira.melynda.prakosa-2018@fkp.unair.ac.id mailto:mira.melynda.prakosa-2018@fkp.unair.ac.id http://dx.doi.org/10.20473/jn.v14i3(si). M. M. PRAKOSA ET AL. 302 | pISSN: 1858-3598  eISSN: 2502-5791 support and employment relations, especially for nurses. This study can contribute to the understanding of how perceived organization support may be used to predict the nurse’s intention to leave their job. MATERIALS AND METHODS The systematic search was conducted in Scopus, Science Direct and SAGE. The studies were published from 2014 to 2019 with the keywords “Perceived Organization Support” and “Turnover Intention” or “Intention to Stay” or “Intention to Leave”. With these terms, we also combined them with other keywords, such as (Nurse * OR Nursing *) for Nursing so then they can retrieve all of the relevant articles. The inclusion criteria of the articles were 1) including an increase in nursing services or a system developed as part of nursing; 2) original research; abstract; 3) the subjects of the study were nurses or employees and 4) the location of the study was a hospital or in industry. The exclusion criteria from the articles were 1) focusing on a location in the community and 2) the research is a thesis or part of a conference process. We extracted the different types of research, research subjects and the research data sources. The research subjects in the 15 studies could be either nurses and employees. In addition, we extracted the results of the articles that discussed the impact of perceived organization support when it comes to increasing the intention to stay. RESULT Figure 1: Literature search flow Selection of the Studies The initial search retrieved a total of total of 10539 studies: 7647 (72,55%) from SAGE, 2292 (21,74%) from Science Direct, and 600 (5,69%) from Scopus. Based on the inclusion and exclusion criteria, the author reviewed each article and reached a consensus regarding the exceptions. The review process for the selected articles developed across three stages, including the title review, abstract review and full text review. We extracted 80 (100 %) studies from the abstract titles and reviews, while a total of 15 articles were selected for the study. The retrieval and screening process has been summarized in Figure 1. Study Methods Based on the research subject, we found that the number of respondents was 9233 total with nurses making up as many as 8103 respondents and employees making up as many as 1130 respondents. Based on the location of the study, we found that 11 studies were conducted in hospitals and 4 studies were conducted in companies. Based on the research design, we found 13 types of cross-sectional design and two quantitative studies with a descriptive correlation design. For data sources, questionnaires were the instrument used from all 15 articles. We identified several instruments used to measure Perceived Organizational Support and Turnover Intention. Perceived Organizational Support was measured using the questionnaires developed by Eisenberger (1986) (Abou Hashish, 2017; Bobbio & Manganelli, 2015; Bohle, 2016; Caesens, Stinglhamber, Demoulin, De Wilde, & Mierop, 2019; Fernet et al., 2017; Filipova, 2011; Kalidass & Bahron, 2015; Kim, Lee, & Shin, 2019; Labrague, McEnroe Petitte, Leocadio, Van Bogaert, & Tsaras, 2018; Ross, 2017) Eisenberger (1997) (Robson & Robson, 2016; Shacklock, Brunetto, Teo, & Farr-Wharton, 2014) and Ling (2006) (J. Y. Liu, Yang, Yang, & Liu, 2015). One measurement was developed by Perceived Organizational Support- Simplified Version Scale (POS-SVS) (W. Liu et al., 2018), Turnover Intention was measurement with questionnaire developed by Camman (1979) (Fernet et al., 2017) and the measurement was modified by Becker (1992) and Mobley (1982) (Kim et al., 2019). Intent to Leave was created by Camman (1979) (Filipova, 2011), and the Turnover Intention Inventory Scale (TIIS) (Labrague et al., 2018) and Intent to Quit was created by Meyer (1993) (Robson & Robson, 2016; Shacklock et al., 2014). The Intent to Remain Scale was developed by Turnley and Feidman (1993) (J. Y. Liu et al., 2015), the Turnover Intention Scale was developed by Lichtenstein (2004) (Ross, 2017), and the Turnover Intention Scale was developed by Lee. The spiritual perceived organizational support questionnaire and the characteristics of the turnover intention questionnaire were tested for reliability using Cronbach’s alpha and everything has been declared reliable. However, there are some instruments that have not been reported on in the validity test.. Search term: Perceived Organization Support AND Turnover intention Intention to stay Intention to leave SAGE: 72,55% Science Direct: 21,74% Scopus: 5,69% 10.539 (100%) articles 80 (100%) full-text articles assessed for eligibility 15 articles retained JURNAL NERS http://e-journal.unair.ac.id/JNERS | 303 DISCUSSION The study results show that perceived organizational support impacts on the nurse’s intention to stay with their organization. High perceived organization support will be a profit for the organization because it can help them to improve the success of the organization, to defend and contribute toward the nurses and increase the productivity of the nurses in providing nursing care. High perceived organization support should be improved to increase the employee's intention to stay. What the organization can do is to fulfill the social-emotional needs of their nurses, to fulfill their promises, to increase their performance–reward expectations, and to create a healthy environment with job security, job satisfaction and autonomy. They should also signal the availability of help and support for their employees. Such a need fulfillment produces a strong sense of belonging felt toward the organization in turn, and they expect more commitment related to the intention to stay (Burke, 2003; Rhoades & Eisenberger, 2002). Perceived Organization Support (POS) is defined as the social exchange relationship that results from the exchange between a nurse and their organization. Nurses with high POS are less likely to seek out and accept jobs in alternative organizations. High POS lowers the nurse’s intention to leave the organization. Apart from that, focusing on the concept of POS would be a key predictor of turnover intention (Kalidass & Bahron, 2015). A study conducted by Ahmed (2012) suggested that organizations that possess and support the management will produce more work that benefits the organization (Bashir Ahmed, 2012). Perceived organizational support can influence the employees to feel a sense of obligation, which can lead to them paying attention to their work and to the organization to help them achieve their goals. This has an effect on the organizational commitments so as to reduce the turnover intention. Nurses have a high perception of organizational support and also the nurse’s commitment is settled within the organization. The review suggests that one of the keys to reducing the percentage of turnover intention in organization is that the human resource managers should be more supportive. There should be a responsible internal relationship between the employees and management, care should extend to the employees’ well-being and they should understand the values of achieving the organization’s goals together. Therefore, there is a need to understand the important roles of POS i.e. the continuance of commitment, affective commitment and normative commitment in order to increase the intention to stay in the organization. The high employee perception of the organization will lower the turnover intention, so the related costs incurred by the organization can be minimized. CONCLUSION Of the fifteen articles reviewed, all showed the positive result that perceived organization support can increase the intention to stay of the nurse. The intention to stay of nurse can be increased if the organization can fulfill the social-emotional needs of their nurses, fulfill their promises an increase their performance–reward expectations, including providing a healthy environment, job security, job satisfaction, autonomy, and signaling the availability of help and support to their employees. High perceived organizational support will increase the profit of the organization because it can help them to improve the success of the organization, to defend and contribute to the nurses’ skills and increase the productivity of the nurses in providing nursing care. High employee perception of the organization rate will lower turnover intention so then the costs incurred in the organization can be minimized. REFERENCES Arshadi Nasrin. The Relationships of Perceived Organization Support (POS) with Organizational Commitment, in Role Performance and Turnover Intention: Mediating Role of Felt Obligation. Procedia Social and Behaviour Science. 2016 Bobbio Andrea and Anna Maria. Antecedents of Hospital Nurse’ Intention to Leave the Organizatio: A Cross Sectional Survey. International Journal of Nursing Studies. 2015 Bohle Sergio, Chambel M, Medina F, Cunha B. The Role of Perceived Organizational Support in Job Insecurity an Performance. 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