Quantitatively applying a person-centered approach in rural health workforce research: An exploratory latent class analysis of early career rural nurses

Aim: To explore the utility of a quantitative person-centred approach to identify subgroups of commencing first-year rural nursesand examine their work attitudes and intentions.
Design: Exploratory cross-sectional survey.
Methods: A survey of commencing first-year nurses was conducted in two Australian rural health districts in 2019 and 2020,with a 91% response rate. A two-step latent class analysis of 159 responses was undertaken with two indicators of perceived pro-fessional opportunity and three indicators of local connection and rural training. Three outcomes assessing work intention andattitudes were compared across subtypes.
Results: Four subgroups (‘classes’) were identified. There were significant differences in the outcomes between the two classesinterpreted as ‘rural-locals’. Rural-locals with the highest perceptions of available professional opportunities had the most posi-tive outcomes of all four classes. Of the two ‘non-local’ classes, the class with high perceptions of professional opportunities wassignificantly happier than the rural-local and non-local classes with lower perceptions; however, class differences in future ruralwork intentions and attitudes were mixed.
Conclusion: The research found subtypes of rural first-year nurses which differed in terms of occupational happiness and futurerural work attitudes. Early career nurses who were rural-locals with highest perceptions of professional opportunities had thehighest intention to remain working rurally. This exploratory research demonstrates the relevance of person-centred and theory-informed approaches to rural health workforce recruitment and retention strategies.
Implications for the Profession: The findings show that ‘rural background’ or ‘local’ are useful but insufficient classifiers to
distinguish among commencing rural nurse health workforce, given rural work attitudes and future work intentions. Furtherattention at organisational and policy levels should be given to rural professional development opportunities for early careernurses to support retention.
Impact: This research has demonstrated how a quantitative person-centred approach can illuminate heterogeneous subgroupswithin a rural health workforce to inform more targeted recruitment and retention strategies. Researchers should look to largerdatasets and methodological resources from psychological theories of work to realise this potential for informing organisationaland governmental policy approaches.