Nurses’ Job Preferences: A Systematic Review of Discrete Choice Experiments

AIM: To systematically review the research on the application of discrete choice experiments (DCEs) in nurses' job preferences. BACKGROUND: As essential frontline healthcare professionals, nurses experience disproportionately high turnover rates globally. This persistent challenge undermines workforce stability, compromises patient care quality, and increases organisational costs. Understanding the underlying factors that influence nurses' job preferences is therefore critical to developing effective recruitment and retention strategies. Discrete choice experiments (DCEs) provide a robust methodological framework for quantifying these preferences and revealing how nurses value different job attributes. METHODS: Ten electronic databases were systematically searched from inception until March 1, 2025. Two researchers independently used the purpose, respondents, explanation, findings, and significance (PREFS) checklist to evaluate the quality of the included studies. Thematic analysis was used to classify the attributes of nurses' job preferences into broad categories and subcategories; the frequency, significance, relative importance, and willingness-to-pay of each attribute in the included studies were analyzed. RESULTS: Twenty-one articles spanning nine countries were included, with a total of 140 individual attributes extracted and divided thematically into three broad categories and eight subcategories. Existence needs, including income, working environment, job stability, and workload, were the most frequently reported broad category. DISCUSSION: This review underscores the decisive influence of nonfinancial attributes on nurses' employment decisions and delineates the nuanced hierarchy of these preferences across multiple dimensions. It is crucial to combine economic and noneconomic factors in formulating targeted incentive policies. CONCLUSION: Nurses weighed both financial and nonfinancial factors when making job choices. Additionally, there were differences in the needs of nurses with different job characteristics, e.g., senior nurses were concerned with work autonomy, while junior nurses were more interested in the working atmosphere. IMPLICATIONS FOR NURSING: Understanding nurses' job preferences can help retain staff and stabilize the nursing workforce. To Policymakers and employers could integrate these evidence-based insights into targeted incentive packages to recruit and retain nursing staff, thereby safeguarding workforce stability.