Effect of Self-Determination Theory (SDT) Elements on the Retention of Nurses at the University of Calabar Teaching Hospital (UCTH), Calabar, Nigeria

Main Article Content

Pepple, Grace Jamie
Ene Okpo Ene-Ita
Dauda, Olayinka Tajudeen
Omosebi, Mayowa Adetunji
Ogar, Godwin Wonah


This research investigated the effect of self-determination theory (SDT) elements on the retention of nurses at the University of Calabar Teaching Hospital (UCTH) in Calabar, Nigeria. The primary focus was to analyze how SDT components like autonomy, competence, and relatedness influence nurse retention at UCTH. Utilizing a cross-sectional research design, the study collected primary data via structured questionnaires from 206 general nurses at UCTH. Descriptive statistics were used to analyze the data, and multiple regression was employed to test the hypotheses. The results indicated that SDT factors—autonomy, competence, and relatedness—had significant positive effects on nurse retention at UCTH. These results underscore the critical importance of nurturing self-determination motivation elements in public hospitals like UCTH to improve nurse retention. Therefore, the study advised that public hospital managers in Nigeria should establish a supportive work environment that promotes nurses' independence in patient care and evaluation. It is also essential to prioritize continuous training and skill enhancement to elevate technical proficiency and the quality of patient care. Furthermore, fostering a culture of social interaction and professional relationships among staff is key to boosting nurses' sense of belonging and worth in the workplace. The study also highlighted the need for extensive research to gain a deeper understanding of the link between SDT factors and employee retention in Nigerian healthcare. Future research should encompass other healthcare professionals in addition to nurses to offer comprehensive insights for effective retention strategies in the Nigerian public health sector.

Keywords: Employee Motivation, Employee Retention, Intrinsic Motivation, Self-Determination Theory, Nurses

Article Details

Effect of Self-Determination Theory (SDT) Elements on the Retention of Nurses at the University of Calabar Teaching Hospital (UCTH), Calabar, Nigeria. (2024). African Journal of Management and Business Research, 15(1), 84-104. https://doi.org/10.62154/6596z753

Copyright (c) 2024 Pepple, Grace Jamie, Ene Okpo Ene-Ita, Dauda, Olayinka Tajudeen, Omosebi, Mayowa Adetunji (Author)

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This work is licensed under a Creative Commons Attribution 4.0 International License.

Pepple, Grace Jamie, University of Calabar, Nigeria.

Department of Business Management,

University of Calabar, Nigeria.

Ene Okpo Ene-Ita, University of Calabar, Nigeria.

Department of Business Management,

University of Calabar, Nigeria.

Dauda, Olayinka Tajudeen, University of Calabar, Nigeria.

Department of Business Management,

University of Calabar, Nigeria.

Omosebi, Mayowa Adetunji, University of Calabar, Nigeria.

Department of Business Management,

University of Calabar, Nigeria.

Ogar, Godwin Wonah, University of Calabar, Nigeria.

Department of Business Management, 

University of Calabar, Nigeria.

Abdi, M. S., Ibrahim, A. A., & Hussein, J. M. (2017). The effect of motivation on employee performance: Case study in Hormuud company in Mogadishu Somalia. International Journal of Development Research, 9(11), 17009-17016.

Abimbola, O. S., Adebisi, A. A., Adebisi, S. S., & Bamisaiye, A. (2020). Motivational factors influencing employee performance in Nigerian healthcare organizations. Journal of Healthcare Management, 14(2), 45-58.

Adegoke, O. S., & Adegboye, O. A. (2018). Impact of leadership styles on employee motivation: A study of healthcare workers in Nigeria. Journal of Health Management, 6(1), 78-92.

Adejoro, L. (November 14, 2022) '57,000 nurses left Nigeria in five years - NANNM': Punch News. https://punchng.com/57000-nurses-left-nigeria-in-five-years-nannm/

Adeola, M. M., & Adebiyi, S. O. (2016). Employee motivation, recruitment practices and banks performance in Nigeria. International Journal of Entrepreneurial Knowledge, 4(2), 45-67.


Adeyemi, O., & Oladipo, A. (2019). Nurse retention and its impact on healthcare delivery in Nigerian public hospitals. Journal of Health Management, 21(3), 284-297.

Afolabi, O. R., Oyekola, A. A., & Adebayo, A. A. (2019). Employee motivation and its implications for healthcare delivery in Nigeria: A case study of public hospitals in Lagos State. Nigerian Journal of Healthcare Management, 7(2), 34-47.

Afolabi, O. S., & Alao, A. A. (2019). Nurse staffing levels and patient outcomes in Nigerian public hospitals: A review of the literature. Journal of Nursing Management, 27(5), 969-978.

Agyapong, G. K., & Antwi, S. K. (2022). Understanding the relationship between employee motivation and organizational productivity: A study of Ghanaian manufacturing firms. Journal of African Business Research, 15(3), 112-125.

Akanbi, B. A., & Mohammed, A. H. (2021). The role of organizational culture in enhancing employee motivation: Evidence from selected healthcare institutions in Nigeria. International Journal of Healthcare Management, 14(3), 112-125.

Akinwale, O., & George, A. (2020). Addressing nurse turnover in Nigeria: Strategies and solutions. African Journal of Nursing and Midwifery, 22(4), 211-225.

Alalade, S.Y. & Oguntodu, J.A. (2015). Motivation and employees' performance in the Nigerian banking industry. International Journal of Economics, Commerce, and Management, 3(4), 78-92.

Alase, G., & Akinbo, T. (2021). Employee motivation and job performance: Empirical evidence from Nigeria. Applied Journal of Economics, Management and Social Sciences, 2(2), 16-23.


Al-Emadi, A. A. Q., Schwabenland, C., & Wei, Q. (2015). The vital role of employee retention in human resource management: A literature review. Journal of Organizational Behavior, 14(3), 7-26.

Ali, B. J., & Anwar, G. (2021). An empirical study of employees' motivation and its influence job satisfaction. International Journal of Engineering, Business and Management, 5(2), 21-30. https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3822723


Alimi, B. G., Ismaila, U., Isa, R., & Garba, A. (2020). Consequences of motivation on medical staff performance of some selected public hospitals in Maiduguri, Borno State, Nigeria. African Scholar Journal of Humanities and Social Sciences, 5(2), 40-53

Anwar, A., Waqas, A., Shakeel, K., & Hassan, S. S. (2018). Impact of intrinsic and extrinsic motivation on employee's retention: A case from call center. International Journal of Academic Research in Business and Social Sciences, 8(6), 652-666.


Aruna, M., & Anitha, J. (2015). Employee retention enablers: Generation Y employees. SCMS Journal of Indian Management, 12(3), 94-108.

Azeez, S. (2017). Human resource management practices and employee retention: A review of literature. Journal of Economics, Management and Trade, 18(2), 1-10.


Baljoon, R. A., Banjar, H. E., & Banakhar, M. A. (2018) Nurses' work motivation and the factors affecting It: A scoping review. International Journal of Nursing & Clinical Practices, 5(1), 277-296.


Bello, M., & Yusuf, A. (2018). The effects of nurse workforce stability on patient outcomes in Nigerian hospitals. International Journal of Nursing Studies, 85, 44-51.

Bing-Jonsson, P. C., Hofoss, D., Kirkevold, M., Bjørk, I. T., & Foss, C. (2016). Sufficient competence in community elderly care? Results from a competence measurement of nursing staff'. BMC Nursing, 15, 1-11. https://link.springer.com/article/10.1186/s12912-016-0124-z#citeas


Chien, G. C., Mao, I., Nergui, E., & Chang, W. (2020). The effect of work motivation on employee performance: Empirical evidence from 4-star hotels in Mongolia. Journal of Human Resources in Hospitality & Tourism, 19(4), 473-495.


Chukwu, C., & Nwafor, E. (2021). Examining the role of nurse retention in enhancing healthcare quality in Nigeria. Nursing Administration Quarterly, 45(2), 174-183.

Ciobanu, A., Androniceanu, A., & Lazaroiu, G. (2019). An integrated psycho-sociological perspective on public employees' motivation and performance. Frontiers in Psychology, 10, 362-401.


Deci, E. L., & Ryan, R. M. (1985) Intrinsic motivation and self-determination in human behaviour. Perspectives in Social Psychology, 4, 11-40.


Deci, E. L., & Ryan, R. M. (2000). The "what" and "why" of goal pursuits: Human needs and the self-determination of behavior. Psychological Inquiry, 11(4), 227-268.


Deci, E. L., Olafsen, A. H. & Ryan, R. M. (2017). Self-determination theory in work organizations: The state of a science. Annual Review of Organizational Psychology and Organizational Behaviour, 4, 19-43.


Druetz, T., Kadio, K., Haddad, S., Kouanda, S., & Ridde, V. (2015). Do community health workers perceive mechanisms associated with the success of community case management of malaria? A qualitative study from Burkina Faso. Social Science & Medicine, 124, 232-240.


Ede, M. O., Okafor, C. J., & Obiweluozor, N. (2020). Factors influencing job satisfaction and turnover intentions among nurses in public hospitals in Nigeria. International Journal of Nursing Studies, 107, 103-126.

Edewor, P. A., & Fatusin, A. F. (2018). Factors influencing nurse retention in Nigeria: A qualitative study. International Journal of Nursing Practice, 24(1), 126-139.

Ekundayo, O. A. (2018). The impact of motivation on employee performance in selected insurance companies in Nigeria. International Journal of African Development, 5(1), 5-23.

Elomien, E., Nchuchuwe, F.F., Idowu, O.A., Onabote, A. & Osabohien, R., (2021). Employee motivation and industrial output in Nigeria. Humanities and Social Sciences Letters, 9(1), 24-33.


Emeka, N., Amaka, O. & Ejim, E.P. (2015). The effect of employee motivation on organizational performance of selected manufacturing firms in Enugu State. World Journal of Management and Behavioral Studies, 3(1), 1-8.


Fillol, A., Lohmann, J., Turcotte-Tremblay, A. M., Somé, P. A., & Ridde, V. (2019). The importance of leadership and organizational capacity in shaping health workers' motivational reactions to performance-based financing: A multiple case study in Burkina Faso. International Journal of Health Policy and Management, 8(5), 272-291.


Gagné, M., Deci, E. L., & Ryan, R. M. (2018). Self-determination theory applied to work motivation and organizational behaviour. The SAGE handbook of industrial, work & organizational psychology: Organizational psychology, 2, 97-121.


Good, M. J., (2023). American medicine: The quest for competence. University of California Press.

Hassan, Z., & Govindhasamy, C. (2020). An investigation on extrinsic and intrinsic rewards on employee retention among Gen Y: A study in Malaysian manufacturing companies. Journal of Business and Economic Analysis, 3(01), 55-69.


Hee, O. C., & Rhung, L. X. (2019). Motivation and employee retention among Millennials in Malaysia. International Journal of Academic Research in Business and Social Sciences, 9(2), 876-884.


Hood, C., & Patton, R. (2022). Exploring the role of psychological need fulfilment on stress, job satisfaction and turnover intention in support staff working in inpatient mental health hospitals in the NHS: A self-determination theory perspective. Journal of Mental Health, 31(5), 692-698.


Howard, J., Gagné, M., Morin, A. J., & Van den Broeck, A. (2016). Motivation profiles at work: A self-determination theory approach. Journal of Vocational Behaviour, 95,74-89.


Hu, P., & Zhang, J. (2017). A pathway to learner autonomy: A self-determination theory perspective. Asia Pacific Education Review, 18, 147-157.


Kanat-Maymon, Y., Elimelech, M. & Roth, G. (2020). Work motivations as antecedents and outcomes of leadership: Integrating self-determination theory and the full range leadership theory. European Management Journal, 38(4), 555-564.


Kaur, P., Stoltzfus, J., & Yellapu, V. (2018). Descriptive statistics. International Journal of Academic Medicine, 4(1), 60-63.


Keith, T. Z. (2019). Multiple regression and beyond: An introduction to multiple regression and structural equation modeling. Routledge.


Kolo, E. S. (2018). Job satisfaction among healthcare workers in a tertiary center in Kano, Northwestern Nigeria. Nigerian Journal of Basic and Clinical Sciences, 15(1), 87-91.


Kuranchie-Mensah, E. B., & Amponsah-Tawiah, K. (2016). Employee motivation and work performance: A comparative study of mining companies in Ghana. Journal of Industrial Engineering and Management, 9(2),.255-309.


Kuswati, Y. (2020). The effect of motivation on employee performance. Budapest International Research and Critics Institute-Journal, 3(2), 995-1002.


Lee, M. T., & Raschke, R. L. (2016). Understanding employee motivation and organizational performance: Arguments for a set-theoretic approach. Journal of Innovation & Knowledge, 1(3), 162-169.


Lee, Y. S., & Eun, Y. (2016). The effect of the flipped learning on self-efficacy, critical thinking disposition, and communication competence of nursing students. The Journal of Korean Academic Society of Nursing Education, 22(4), 567-576.


Lohmann, J., Houlfort, N., & De Allegri, M. (2016). Crowding out or no crowding out? A self-determination theory approach to health worker motivation in performance-based financing. Social Science & Medicine, 169, 1-8.


Lohmann, J., Muula, A. S., Houlfort, N., & De Allegri, M. (2018). How does performance-based financing affect health workers' intrinsic motivation? A self-determination theory-based mixed-methods study in Malawi. Social Science & Medicine, 208, 1-8.


Makki, A. & Abid, M. (2017). Influence of intrinsic and extrinsic motivation on employee's task performance. Studies in Asian Social Science, 4(1), 38-43.


Manganelli, L., Thibault-Landry, A., Forest, J., & Carpentier, J. (2018). Self-determination theory can help you generate performance and well-being in the workplace: A review of the literature. Advances in Developing Human Resources, 20(2), 227-240.


Marewo, N. T., Mutongi, C., Nyoni, T., & Nyoni, S. P. (2020). The impact of employee motivation on employee performance. International Journal of Advance Research and Innovative Ideas in Education, 6(6), 1487-1502.

Marufu, T.C., Collins, A., Vargas, L., Gillespie, L. & Almghairbi, D. (2021). Factors influencing retention among hospital nurses: Systematic review. British Journal of Nursing, 30(5), 302-308.


Molina-Mula, J., & Gallo-Estrada, J. (2020). Impact of nurse-patient relationship on quality of care and patient autonomy in decision-making. International Journal of Environmental Research and Public Health, 17(3), 835-853.


Mutsuddi, I. (2016). Employee retention and engagement practices in the healthcare sector: A study on medica super-specialty hospital, Kolkata. Delhi Business Review, 17(1), 65-78.


Nibbelink, C. W., & Brewer, B. B. (2018). Decision‐making in nursing practice: An integrative literature review. Journal of Clinical Nursing, 27(5-6), 917-928.


Nweke, J., & Ugochukwu, C. (2021). Strategies for enhancing nurse retention in Nigerian public health systems. Journal of Nursing Management, 29(3), 467-474.

Nwosu, C., & Ugwu, C. (2021). Burnout and occupational stress among nurses in Nigerian public hospitals: The moderating role of social support. Journal of Health Psychology, 26(11), 1867-1882.

Nxumalo, B., & Dlamini, N. (2017). The role of employee motivation in enhancing organizational performance: Insights from South African information technology sector. South African Journal of Business Management, 48(1), 45-58.

Ogonda, B., & Kipkulei, J. (2018). Employee motivation and organizational performance: Evidence from Kenyan banking sector. International Journal of Business and Management, 13(5), 68-82.

Okoroafor, S.C., Ongom, M., Salihu, D., Mohammed, B., Ahmat, A., Osubor, M., Nyoni, J., Nwachukwu, C., Bassey, J. & Alemu, W., (2021). Retention and motivation of health workers in remote and rural areas in Cross River State, Nigeria: A discrete choice experiment. Journal of Public Health, 43(1), 46-53.


Olajide, F., Adeyemo, O., & Oyetunde, M. (2022). Impact of work environment on job satisfaction and burnout among nurses in public hospitals in South-West Nigeria. BMC Nursing, 21, 110-128.

Olorunfemi, O., Agbo, D.I., Olorunfemi, O.M. & Okupapat, E.O. (2020). Impact of the emigration of nurses on health care delivery system in selected hospitals, Benin-City, Edo State, Nigeria. Journal of Integrative Nursing, 2(3), 110-115.


Olusadum, N.J. & Anulika, N.J. (2018). Impact of motivation on employee performance: A study of Alvan Ikoku Federal College of Education. Sigma, 1(1), 53-65.


Raza, M. Y., Akhtar, M. W., Husnain, M., & Akhtar, M. S. (2015). The impact of intrinsic motivation on employee's job satisfaction. Management and Organizational Studies, 2(3), 80-88.


Rigby, C. S., & Ryan, R. M. (2018). Self-determination theory in human resource development: New directions and practical considerations. Advances in Developing Human Resources, 20(2), 133-147.


Ryan, R. M., Deci, E. L., Grolnick, W. S., & La Guardia, J. G. (2015). The significance of autonomy and autonomy support in psychological development and psychopathology. Developmental Psychopathology, 1, 795-849.


Salvatore, D., Numerato, D., & Fattore, G. (2018). Physicians' professional autonomy and their organizational identification with their hospital. BMC Health Services Research, 18, 1-11.


Shah, M., & Asad, M. (2018). Effect of motivation on employee retention: Mediating role of perceived organizational support. European Online Journal of Natural and Social Sciences, 7(2), 511-528.

Trépanier, S.G., Forest, J., Fernet, C. & Austin, S. (2015). On the psychological and motivational processes linking job characteristics to employee functioning: Insights from self-determination theory. Work & Stress, 29(3), 286-305.


Tripathy, J. P., Goel, S., & Kumar, A. M. (2016). Measuring and understanding motivation among community health workers in rural health facilities in India-a mixed method study. BMC Health Services Research, 16, 1-10.


Ualikhanova, B. S., Baizak, U. A., Turmambekov, T. A., Kurbanbekov, B. A., Sarybaeva, A. H., & Rumbeshta, E. A. (2015). Formation of medical students' competences in the Republic of Kazakhstan. Indian Journal of Science and Technology, 6(1), 89-104


Van de Klundert, J., van Dongen-van den Broek, J., Yesuf, E.M., Vreugdenhil, J. & Yimer, S.M., (2018). We are planning to leave, all of us-A realist study of mechanisms explaining healthcare employee turnover in rural Ethiopia. Human Resources for Health, 16(1), 1-13.


Varma, C. (2017). Importance of employee motivation and job satisfaction for organizational performance. International Journal of Social Science & Interdisciplinary Research, 6(2), 109-128. https://ssrn.com/abstract=3073813

Widarti, K., & Santoso, S. (2019). The impact of employee motivation on organizational productivity: A case study of Indonesian manufacturing industry. Journal of Management and Sustainability, 9(2), 25-35.

Wulf, G., & Lewthwaite, R. (2016). Optimizing performance through intrinsic motivation and attention for learning: The OPTIMAL theory of motor learning. Psychonomic Bulletin & Review, 23, pp.1382-1414. https://doi.org/10.3758/s13423-015-0999-9


Yuk, S., & Yu, S. (2023). The effect of professional autonomy and nursing work environment on nurses' patient safety activities: A perspective on magnet hospitals. Journal of Nursing Management, 20(2), 67-91. https://doi.org/10.1155/2023/5587501