This study investigates the effect of internal branding and perceived supervisor support on turnover intention, with work engagement as a mediating variable among nurses at RSUP dr. Soeradji Tirtonegoro Klaten. A quantitative approach was used with 120 nurses as respondents. Data were collected via questionnaires and analyzed using descriptive statistics and Structural Equation Modeling (SEM). Results show that internal branding and perceived supervisor support positively affect work engagement. Internal branding indirectly reduces turnover intention through work engagement, while perceived supervisor support does not show a significant indirect effect. These findings highlight the importance of internal branding in enhancing work engagement and reducing turnover intention among nurses.
With the state of business competence with such rapid changes, many companies are trying to maintain the continuity of existence and also the welfare of their employees. The ability to work effectively and efficiently is indispensable for employees to help their organization achieve its desired goals (Ryba, 2020). Health Human Resources (HR) is the main element in driving health development. Compared to other health workers in hospitals, such as doctors, paramedics, sanitarians, administration, and others, nurses are the largest part of health workers who provide nursing care in hospitals. Therefore, the role of a nursing manager is needed to regulate or supervise a number of nurses in carrying out daily nursing care.
The increasing number of patients and labor shortages affect the ratio of nurses (Haddad, 2020). This can increase the work that must be carried out by one nurse to increase stress and fatigue both mentally and physically. With these problems, WHO also recommends that it be formed as an opportunity to increase job retention for nurses and reduce turnover rates (Gunawan, 2022).
Although employee turnover intentions increased in 2020, the figure remained high in 2021 and increased in 2022 from U.S. Bureau of Labor Statistics data. In 2022, the employee turnover rate for the entire industry has an average value of 47% and the turnover rate by the Education and Health Services industry is 38%. For 2021, the turnover intention for the entire industry has an average value of 47% and the turnover rate by the Education and Health Services industry is 37%. Judging from this statistical data, most industries should be better. However, there was an increase of 47.4 million people quitting in 2021, and more than 50 million people quitting in 2022. So that turnover intention continues to increase (Hansen, 2024).
RSUP dr. Soeradji Tirtonegoro as a government agency designated as an agency with financial management of the Public Service Agency, that the human resources (employees) owned are not only civil servants (PNS), but also non-civil servants/Public Service Agency. This hospital is located on Jalan KRT Jl. dr. Soeradji Tirtonegoro No.1, Dusun 1, Tegalyoso, South Klaten District, Klaten Regency, Central Java. From the 2023 performance accountability report of Soeradji Tirtonegoro Klaten Hospital, there are still major problems that occur in the work environment, such as meeting labor needs that have not met expectations or labor patterns caused by poor workload identification. In addition, there is a low level of organizational commitment and work culture among employees (Widyaswati, 2024). In this data, there is a low level of organizational commitment, this shows that when employee commitment to the organization is low, employees will intend to leave or turnover intention from the organization (Setiawan & Harahap, 2016).
Turnover intention refers to an emotional state in which an organization's employees are dissatisfied with their current job and want to quit their job (Ahn & Kim, 2022). Work engagement represents the positive and satisfying mental state of each employee, which includes components such as vitality, dedication, and commitment. Specifically, vitality indicates a willingness to carry out the tasks assigned to you by injecting a high level of physical and mental energy, and
dedication refers to feeling passionate about work as well as having a sense of pride and challenge (Bae et al., 2022). Employees who have a good awareness of internal branding, then their willingness to turnover intentions in a conscious and planned manner may be reduced (Park, 2022). Perceived supervisory support tends to minimize emotional fatigue and increase employees' sense of personal achievement, thereby minimizing turnover intention (Yeun & Kim, 2015). Internal branding encourages employee commitment in achieving organizational goals and fosters a sense of ownership and work engagement (Cho, 2014). There is often a limited investment in employee resources when there is a perception of absenteeism or a low level of perceived supervisor support. However, supervisor feedback motivates employees to learn new abilities and make plans to engage in their necessary work (Kissi et al., 2023).
This study aims to examine the influence of internal branding and perceived supervisor support on turnover intention with work involvement as a mediating variable among nurses at RSUP dr. Soeradji Tirtonegoro Klaten.
Basically, the term internal branding is better known as internal employer branding. He refers to the human resource process in aligning employee values with the company's vision and mission. The main goal of the initiative is to create a work culture where all employees strive to achieve the same goal, which is the company's main mission. Internal branding also focuses on developing employees' understanding of their company. This method can provide a sense of compatibility between employee values and business entities, as well as create a sense of commitment in employees to continue to pursue the company's vision. Internal branding can also be one way for employees to understand the message and behave like the company's brand identity. In other words, brand identity will be stronger than a reflection of employee attitudes in the eyes of the public (Ishak, 2023). Each employee must understand the suggested characteristics of the brand, embrace the brand (the brand as an employee role model) and believe in the brand (Latifah & Muafi, 2021).
From the description above, it can be concluded that internal branding is a human resource process to build and strengthen the company's identity, culture, and values among employees. The goal is for these human resources to be able to create a strong understanding of the company's brand, motivate employees to contribute positively to the brand, and improve the quality of service provided to customers. In practice, internal branding involves effective communication, training, and employee development to ensure that they understand, adopt, and embody the company's values and goals.
Perceived supervisor support is the feeling that employees receive when they get a sense of protection from their supervisor, so they will be more satisfied, committed, and productive. The impact of perceived supervisor support for employees can have both positive and negative impacts, affecting various aspects
of work and well-being (Aprilia, 2023). Perceived supervisor support can reduce the loss of productivity due to presenteeism. Employees who feel supported by supervisors are more likely to be absent from work when sick, which can increase productivity. The negative impact is a loss of productivity, if employees feel not supported by their supervisors, they may be more likely to be present at work when sick, which can reduce their productivity. This can have a negative impact on the organization's performance.
Work engagement is how a person shows their job self-preference to improve the relationship between themselves and their job, which can increase role performance by investing in themselves cognitively, emotionally, and physically. It can also be said that employees will easily be confident in their work and have better insight and understanding of their work (Hebert & Porter, 2023). If the employee is able to recognize himself about his work psychologically with his work and emphasize the importance of his work to the organization, then the employee can be said to have a high work attachment and care about the type of work being carried out and is very in tune with the type of work (Chen et al., 2022).
From the description above, it can be concluded that work engagement is a psychology that can indicate a positive attitude, active work, and stress due to work, so it is meant by work attachment. So that workers can use a person's preferences to carry out professional work in order to strengthen the bond between individuals and their colleagues. As a result, it will increase organizational productivity.
Turnover intention is the subjective desire of employees to leave their job and the organization where they work in the near future and steps in the process of considering an employee to leave the organization, starting from the assessment of the current job, satisfaction with the organization and the job, to the consideration of costs and consequences of leaving as well as the assessment of the available alternative jobs. Although turnover intention is the initial initial decision to leave the organization, the final decision to leave the organization is usually accompanied by a real action to leave (turnover).
In previous research, the organizational management culture dimension in internal branding had a negative effect on turnover intention and the internal communication dimension in internal branding had a positive effect on turnover intention (Park & Kim, 2024). Furthermore, he explained that if employees have a good awareness of internal branding, then their willingness to turnover intentions consciously and planned may be reduced (Park, 2022). It is also reported that organizational culture accompanied by intimacy and bonds between colleagues (internal branding) in the organization can reduce turnover intention (Ju et al., 2018).
In previous research, the cultural dimension of organizational management in internal branding had a positive effect on work engagement. The internal communication dimension in internal branding has a negative effect on work engagement (Park & Kim, 2024). Various previous studies have reported that internal branding has a significant influence on employee work engagement, or work dedication (Park, 2022). For example, management and internal branding support in sports organizations has a positive impact on workplace engagement, and education and training for Taekwondo employees have a positive impact on their work performance (So-Kyum, 2022). Therefore, the following research hypothesis is determined, namely internal branding has a positive effect on work engagement.
This research uses a quantitative approach and is conducted with a field study on nurses in the Indonesian health industry, namely dr. Soeradji Tirtonegoro Hospital which is located at Jalan KRT Jl. dr. Soeradji Tirtonegoro No.1, Dusun 1, Tegalyoso, Kec. The individual units used in this study are individuals from contract BLUD nurses and PPPK dr. Soeradji Tirtonegoro Hospital. Data collection for this study was carried out on a cross sectional basis because the data was taken in a specified period of time and disseminated through questionnaires. In this study, the independent variable is internal branding. Then his statement in the internal variable questionnaire of branding oriented to the research (Park & Kim, 2024) where there are 2 dimensions used with a total of 11 question items. Furthermore, in this sub-chapter, the way of collecting data is carried out in a direct way with the aim of obtaining valid information and sourced directly from the source.
Data on the population of non-civil servant nurses at dr. Soeradji Tirtonegoro Hospital is 136 people. For the samplers, an online questionnaire was distributed to 136 non-civil servant nurses at dr. Soeradji Tirtonegoro Klaten Hospital as a population. However, the questionnaire that returned was only filled out by 120 non-civil servant nurses at dr. Soeradji Tirtonegoro Klaten Hospital. Then the number of samples used in this study is 120. Because the sample has met the factor loading based sample according to (Hair et al., 2019). The instrument test is carried out by testing validity and reliability.
Table 1. Reliability Test Results
| No. | Variabel | Cronbach Alpha | Results |
|---|---|---|---|
| 1 | Internal Branding | 0,892 | Reliable |
| 2 | Perceived Supervisor Support | 0,884 | Reliable |
| 3 | Work Engagement | 0,955 | Reliable |
| 4 | Turnover Intention | 0,945 | Reliable |
From the table, it can be explained that the results of all
internal branding variables
considered appropriate or
After carrying out
Table 2. Direct Influence Sequence Between Variables
| Hypothesis | Estimated Value | P-Value | Results |
|---|---|---|---|
| H1: Internal Branding has a negative effect on Turnover Intention | -0,085 | 0,679 | Not Supported |
| H2: Internal Branding has a positive effect on Work Engagement | 0,542 | 0,000 | Supported |
| H3: Perceived Supervisor Support berpengaruh negatif terhadap Turnover Intention | -0,121 | 0,408 | Not Supported |
| H4: Perceived Supervisor Support has a positive effect on Work Engagement | 0,085 | 0,036 | Supported |
| H5: Work Engagement Negatively Affects Turnover Intention | -0,439 | 0,004 | Supported |
| H6: Internal Branding has a negative effect on Turnover Intention mediated by Work Engagement (IB→WE→TI) | -2,353 | 0,018 | Supported |
| H7: Perceived Supervisor Support has a negative effect on Turnover Intention mediated by Work Engagement (PSS→WE→TI) | -0,870 | 0,384 | Not Supported |
Tabel 3.1 Hypothesis Test Results 1
| Hypothesis | Estimation (β) | P-Value | Result |
|---|---|---|---|
| Ha: Internal Branding has a negative effect on Turnover Intention | -0,085 | 0,679 | Not Supported |
Based on the test results in the table above, it was found that
the estimated value was (β) -0.085. However, based on the results of
the test, a significant value of 0.679 > 0.05 was obtained, so
that Ho was supported and Ha was not supported. So, it can be
concluded that
Table 4.2
| Hypothesis | Estimation (β) | P-Value | Results |
|---|---|---|---|
| Ha: Internal Branding has a positive effect on Work Engagement | 0,542 | 0,000 | Supported |
Based on the test results in the table above, an estimated value
of (β) 0.542 was found. Based on the results of the test, a
significant value of 0.000 ≤ 0.05 was obtained so that Ho was not
supported and Ha was supported. So, it can be concluded that
Table 5. Hypothesis Test Results 3
| Hypothesis | Estimation (β) | P-Value | Results |
|---|---|---|---|
| Ha: Perceived Supervisor Support has a negative effect on Turnover Intention | -0,121 | 0,408 | Not Supported |
Based on the test results in the table above, it was found that
the estimated value was (β) -0.121. However, based on the results
of the test, a significant value of 0.408 > 0.05 was obtained
so that Ho was supported and Ha was not supported. So, it can be
concluded that
Table 6. Hypothesis Test Results 4
| Hypothesis | Estimation (β) | P-Value | Results |
|---|---|---|---|
| Ha: Perceived Supervisor Support has a positive effect on Work Engagement | 0,085 | 0,036 | Supported |
Based on the test results in the table above, an estimated
value of (β) 0.085 was found. Based on the results of the test, a
significant value of 0.036 ≤ 0.05 was obtained, so that Ho was not
supported and Ha was supported. So it can be concluded that
Table 7.
| Hypothesis | Estimation (β) | P-Value | Results |
|---|---|---|---|
| Ha: Work Engagement has a negative effect on Turnover Intention | -0,439 | 0,004 | Supported |
Based on the test results in the table above, an estimated value
of (β) -0.439 was found. Based on the results of the test, a
significant value of 0.004 ≤ 0.05 was obtained so that Ho was not
supported and Ha was supported. So, it can be concluded that
Table 8.
| Hypothesis | Estimation (β) | P-Value | Results |
|---|---|---|---|
| H6: Internal Branding has a negative effect on Turnover Intention mediated by Work Engagement | -2,353 | 0,018 | Supported |
Based on the test results in the table above, an estimated
value of (β) -2.353 was found. Based on the results of the test, a
significant value of 0.018 ≤ 0.05 was obtained, so that Ho was not
supported and Ha was supported. So, it can be concluded that
Table 9.
| Hypothesis | Estimation (β) | P-Value | Results |
|---|---|---|---|
| Ha: Perceived Supervisor Support berpengaruh negatif terhadap Turnover Intention yang dimediasi Work Engagement | -0,870 | 0,384 | Not Supported |
Based on the test results in the table above, an estimated value of (β) -0.870 was found. However, based on the results of the test, a significant value of 0.384
> 0.05 was obtained, so that Ho was supported and Ha was not
supported. So, it can be concluded that
The first hypothesis test found that internal branding does not have a negative effect on turnover intention. This shows that internal branding has not been able to reduce the turnover intention rate among nurses at dr. Soeradji Tirtonego Hospital. The results of the current study are different from previous studies, due to several factors. Some of the main reasons are due to differences in the location of the region or country, individual units of analysis, and the type of industry that was researched in previous and current research. The majority of
>21-30 year olds also identify that nurses are still in the early stages of their careers. So, the increase in the internal branding of dr. Soeradji Tirtonegoro Hospital still does not help reduce their intention to leave work. The nurse at dr. Soeradji Tirtonegoro Hospital felt like to leave the current organization.
The second hypothesis test was found to have a positive effect on internal branding on work engagement. This shows that RSUP dr. Soeradji Tirtonegoro can create and build in communicating the core values, vision, and organizational culture to nurses (internal branding) which is positive towards the tendency of nurses to feel more involved, motivated, and committed to their work. This hypothesis is supported by previous research findings, management support and internal branding in sports organizations have a positive impact on work engagement in the workplace, and education and training for Taekwondo employees have a positive impact on their work performance (Park & Kim, 2024). So, it can be concluded based on the results of the test that internal branding has a positive effect on work engagement in nurses at dr. Soeradji Tirtonegoro Klaten Hospital.
The third hypothesis test found that perceived supervisor support did not have a negative effect on turnover intention. This shows that perceived supervisor support has not been able to reduce the turnover intention rate among nurses at dr. Soeradji Tirtonego Hospital. Although according to research (Qaisar et al., 2019), perceived supervisory support in training and motivation services greatly affects employees' desire to leave the company. The results of the current study are different from previous studies, due to several factors. Some of the main reasons are due to differences in the location of the region or country, individual units of analysis, and the type of industry that was researched in previous and current research.
Although perceived supervisor support is often considered an important strategy to increase employee loyalty and retain employees, the results of the study show that perceived supervisor support has not been able to reduce the turnover intention rate among nurses at dr. Soeradji Tirtonegoro Hospital. So, it can be concluded based on the results of the test that perceived supervisor support does not have a negative effect on turnover intention in nurses at dr. Soeradji Tirtonegoro Klaten Hospital. Even though the hospital has increased their perceived supervisor support, nurses will still have the intention to leave their jobs.
The fourth hypothesis test found positive effects between perceived supervisor support on work engagement. This shows that Dr. Soeradji Tirtonegoro Hospital can create emotional support and provide practical assistance to nurses who are positive towards the tendency of nurses to increase work attachment such as performance, productivity, health and safety as well as increased organizational commitment.
This hypothesis is supported by the findings of previous research, such as a survey of 253 employees of a mining organization in South Africa reporting
that employee perception of increased perceived supervisor support increases work engagement among employees (Kissi et al., 2023). So, it can be concluded based on the results of the test that perceived supervisor support has a positive effect on work engagement in nurses at dr. Soeradji Tirtonegoro Klaten Hospital. So, it can be concluded based on the results of the test that perceived supervisor support has a positive effect on work engagement in nurses at dr. Soeradji Tirtonegoro Klaten Hospital.
The fifth hypothesis test was found to have a negative effect on work engagement on turnover intention. This shows that dr. Soeradji Tirtonegoro Hospital can create a very positive level of attachment and work spirit for nurses who can provide a sense of satisfaction and clear goals in their work, which in the end can reduce their intention to leave the organization. This hypothesis is supported by previous research findings, such as employees who have work engagement are more likely to be overly attached to their bosses, thus lowering their intention to leave (Kissi et al., 2023).
Previous research has shown that low work engagement tends to stimulate higher employee turnover intentions (Cao et al., 2020). Work engagement reportedly affects employee turnover intentions directly or indirectly (De-Simone et al., 2018). So, it can be concluded based on the results of the test that work engagement has a negative effect on turnover intention in nurses at dr. Soeradji Tirtonegoro Klaten Hospital.
The sixth hypothesis test found that internal branding has a negative effect on turnover intention mediated by work engagement. This shows that RSUP dr. Soeradji Tirtonegoro can create a mediating role of work engagement in helping to better understand the mechanism underlying the negative relationship between internal branding and turnover intention. With good internal branding such as building and communicating the organization's core values, vision, and culture to nurses, nurses tend to be more involved in their work, which in turn reduces their intention to leave dr. Soeradji Tirtonegoro Hospital.
This hypothesis is supported by the findings of previous research, that work engagement may play a mediating role in the relationship between internal branding and turnover intention (Park & Kim, 2024). So, it can be concluded based on the results of the test that internal branding has a negative effect on turnover intention mediated by work engagement in nurses at dr. Soeradji Tirtonegoro Klaten Hospital.
The seventh hypothesis test found that perceived supervisor support does not have a negative effect on turnover intention mediated by work engagement. This shows that perceived supervisor support has not been able to reduce the
level of turnover intention mediated by work engagement among nurses at dr. Soeradji Tirtonego Hospital.
Career development opportunities are the available career development opportunities and work-life balance, which is the ability of employees to balance work and personal life according to (Allen et al., 2003). Furthermore, another factor according to (Hom & Griffeth, 1991) is the perception of external job opportunities, namely the perception of the availability of other jobs that are better and work stress, namely the influence of work stress on the intention to leave. So, it can be concluded based on the results of the test that perceived supervisor support does not have a negative effect on turnover intention mediated by work engagement in nurses at dr. Soeradji Tirtonegoro Klaten Hospital.
The research results show that internal branding and perceived superior support have a positive influence on work engagement. However, there was no significant direct influence of internal branding and perceived supervisor support on turnover intention. However, internal branding influences turnover intention indirectly through work engagement. Perceived supervisor support, in the context of this study, was not shown to influence turnover intentions via job engagement. These findings show the importance of internal branding in increasing nurses' work engagement, which in their partners can reduce their intention to change jobs. The practical implication of this research is the need for greater attention to internal branding strategies and perceived supervisor support in one government hospital to increase nurses' loyalty and work engagement, as well as reduce turnover intentions among them.
The next research is expected to not only research companies in the hospital sector but other sectors such as education, construction, banking, and others. The next study is also expected to use a larger number of respondents so that it can obtain more accurate data and add variables other than those used in this study.