Exploring the Influencing Factors of Experienced Nurses' Retention Behaviour: A Qualitative Study Based on the COM-B Model

Aim: The aim of this study was to explore the factors influencing the retention behaviour of experienced nurses in China, using the capability, opportunity, motivation and behaviour (COM-B) model as a conceptual framework. Design: A qualitative descriptive study based on the COM-B model. Methods: In this qualitative descriptive study, semi-structured interviews were conducted with 22 nurses across 11 cities in the Guangdong-Hong Kong-Macao Great Bay Area of China between March and May 2024. The interviews followed a predefined topic guide derived from the COM-B model. The transcriptions of the interviews were then subjected to deductive thematic analysis. Results: Eleven key themes emerged, which were embedded in three categories of the COM-B model, including capability (physical and mental health, professional knowledge and skills), motivation (increasing income, sense of fulfilment in nursing work, positive colleague relationships and job stability) and opportunity (management, career development opportunities, work–life balance, prejudice against nursing and workload). Conclusions: The study provides new perspectives on factors influencing the retention of experienced nurses in Mainland China, Hong Kong and Macao. The study identified 11 factors that influence nurse retention behaviour, emphasising three distinctive perceptions: the ‘iron rice bowl’, the concept of filial piety and public prejudice towards nursing in Chinese society, which are unique to China compared to other nations. Additionally, it revealed similarities in nurse retention factors across Mainland China, Hong Kong and Macao. Implications for the Profession: To strengthen nurse retention, it is essential to develop tailored strategies for experienced nurses. Future research should also take social culture into account to enhance retention efforts. Reporting Method: This study's reporting adhered to the Consolidated Criteria for Reporting Qualitative Studies (COREQ) checklist. Patient or Public Contribution: No patient or public contribution.