Why Do They Leave? The Counterplans to Continue Working among Preschool Workers in Japan: A Cross-Sectional Survey

Three institutions predominantly care for preschool children in Japan: kindergartens, authorized childcare institutions, and nursery centers. Recently, the turnover rates of preschool workers in these institutions have been high, and Japan has been facing a shortage of kindergarten teachers. The study aimed to provide concrete counterplans to reduce preschool workers’ turnover rate. To determine the causes of turnover, we conducted a cross-sectional survey. We recruited preschool workers from several kindergartens, authorized childcare institutions, and nursery centers in Japan to fill out a survey regarding counterplans for employment. Of the 1002 surveys, 551 (541 women; 10 men) complete surveys were received (response rate: 55%). A total of 295 participants answered that they were unwilling to continue working for longer than five years and completed the questionnaires. The Jiro Kawakita method was used to categorize and analyze the four sections of the counterplan questionnaires. The results showed that the main reasons for high turnover were overtime work, low salary, and difficult human relations. To solve these issues, the counterplan ideas such as workshop ideas and conditions conducive to continuing working longer were related to human relations, work conditions, and mental health.


Introduction
The three institutions that care for preschool children in Japan are kindergartens (3-5 years old), authorized childcare institutions (from birth to 5 years old), and nursery centers (from birth to 5 years old). According to the Cabinet Office of Japan, kindergarten is defined as a preschool that offers education-based playing and singing, practical activities such as drawing, and social interaction as part of the transition from home to school; it is an ambulatory institution that cares for babies and toddlers whose guardians are working. An authorized childcare institution is a center that has both kindergarten and nursery center functions. Recently, the turnover rates of preschool workers in these institutions have been high [1,2]. The importance of reducing the turnover rate among preschool workers is increasing in developed countries, including those in East Asia [3], and Japan has been facing a shortage of kindergarten teachers. These workforce changes have resulted in insufficient childcare in these institutions [4].
Researchers have attempted to solve this problem by identifying individual and environmental factors that correlate with preschool workers' willingness to continue working. In particular, a previous study found that sex, age, mental health, social support, and work engagement were associated with teachers' willingness to continue working [4]. Another study suggested that age, family environment, work responsibilities, mental health, and work engagement were significantly associated with the willingness to continue working. Accordingly, welfare benefits and individual support systems can be key elements in encouraging teachers to continue working and improve their job satisfaction, mental health, and wellbeing. In addition, balanced work conditions and workers' high agreement with workplace childcare/education policies may reduce turnover [5].
Although earlier studies have provided suggestions for reducing the turnover rate, more concrete counterplans should be investigated to implement them. Thus, the main objective of this study was to determine the reasons preschool/nursery center/kindergarten teachers and workers leave employment and to provide concrete counterplans to reduce the turnover rate in these occupations. It aimed to find counterplans to reduce preschool workers' turnover rate and contribute to the social issues in Japan.

Participants
This study recruited 1002 preschool workers in Japan as its potential participants. Of them, 451 participants either did not fully answer the questionnaires or did not return them. Thus, 551 complete surveys were received (response rate: 55%). Finally, of the 551 potential participants, 295 answered that they were unwilling to continue working for longer than five years and completed the questionnaires.
Informed consent was obtained from all participants prior to the study. The study was approved by the Ethics Committee of Nishi Kyushu University (approval No. 21VDV15) and complied with the Declaration of Helsinki [6].

Procedure
The study was conducted in 2018 as a cross-sectional survey. We recruited participants from kindergartens, authorized childcare institutions, and nursery centers in representative cities in Japan. We included only full-time teachers and individuals working in non-managerial positions to ensure that part-time workers with fixed-term contracts and managers would not affect the results. The study questionnaires took approximately ten minutes for participants to complete. All participants provided written informed consent in their workplaces and completed the survey about counterplans that could reduce the turnover rate. All questionnaire responses were self-reported and anonymous, and participants returned the completed questionnaires in sealed envelopes.

Measures
First, the participants were asked to choose the reasons for their unwillingness to continue working for longer than five years. Second, they were asked about their motivations for leaving and counterplan ideas. The counterplans questionnaire comprised four sections: reasons for considering leaving employment, contents of overtime work, necessary workshops to solve work problems, and ideas for continuing to work longer. These questions were all answered descriptively.

Data Analysis
All the data collected in this study were descriptive data. Thus, data categorization was required to calculate the result. To this end, four sections of the counterplans questionnaire described in the Measures section (above) were categorized using the Jiro Kawakita method (KJ method), also known as affinity diagramming [7]. The KJ method is widely used in participatory learning as a means to collect and organize information. It extracts and categorizes key words from the results of the questionnaire using text mining.

Workshop Idea Categories
The workshop ideas were divided into the following eight sections by types of ideas: "children's guardians", "taking care of children", "understanding children", "place to share suffering", "basic skills for work", "mental health", "the way of working", and "others." The ideas to solve job problems with the highest percentage were "the ways to take care of/support children's guardians", followed by "the ways to take care of children requiring support" and "create places to share suffering and advisement" ( Table 4). The ideas regarding conditions conducive to continue working longer were divided into the following 12 sections based on types of ideas: "employment conditions", "workforce", "workload", "human relations", "relationship with boss/seniors", "work environment", "welfare benefits", "duty framework", "taking care of children", "taking care of children's guardians", "mental health", and "others." The ideas with the highest percentages were "better salary", followed by "more workers", and "easier to have holidays/private time" (Table 5). Common understanding between guardians and childcare workers 18 (4) 24 Workshop for children's guardians 11 (2) 38 The ways to support parents and children 7 (1) Taking care of children 2 The ways to take care of children requiring support 39 (8)  7 The ways to take care of children with developmental disorder 27 (6)  12 The ways to take care of children 21 (4) Case examination of children 14 (3)  21 Highly professional workshop 12 (3)  25 Contents of childcare/the ways of childcare 11 (2) 31 The ways to take care of children in the grey zone/undiagnosed 9 (2) 32 Methods of playing and hand playing 9 (2) 34 Practical workshop/experience-based workshop 9 (2) 40 Skill up 7 (1) Understanding children 29 Group discussion 10 (2) 41 The ways to understand children 6 (1) 42 The ways to understand disability 6 (1) 43 Special needs of children 6 (1) Place to share suffering 3 Create places to share suffering and advisement 35 (7) 4 Interaction with other kindergartens and workers working in different places 34 (7) 36 Interaction with coeval workers 9 (2) 37 Interaction with childminders 8 (2) Basic skills for work The ways to think 6 (1) 46 Relaxation 6 (1) The ways of working 9 Workshop for directors and bosses 26 (5)  14 Methods for efficient work 18 (4) 22 High quality workshop inside of kindergarten 12 (3)  23 The ways to work/work system 11 (2) 26 The ways of class governance 10 (2) 33 How to work 9 (2) 35 All-hands workshop 9 (2) 44 Cooperative framework 6 (1)

Others 5
Workshop is burden 30 (6) 6 The problems cannot be solved with workshops 29 (6) 10 Others 24 (5) 39 Workshop is unnecessary 7 (1) The numbers on the left indicate the ideas' ascending ranking by n (%). The ideas were divided into eight sections based on the types of ideas. The workshop ideas to solve job problems with the highest percentages were "the ways to take care of/support guardians", followed by "the ways to take care of children requiring support" and "create places to share suffering and advisement". Table 5. Categorized ideas of effective conditions for preschool workers to stay longer in the job.

Workload 4
Less or simplification of administrative work/document work 81 (11)  5 Less take-out work 76 (11)  7 Less/simplification of kindergarten festivals 48 (7)  8 Less/no overtime work 47 (7) 9 Less workload 46 (6) 12 Can do document work in work time 35 (5) 20 Effective and equal assigning tasks 20 (3)  Less burden on the ones in charge 9 (1) 47 Good workplace atmosphere 8 (1) Advancement in social status of kindergarten teachers 12 (2) The numbers on the left indicate the ideas' ascending ranking by n (%). The ideas were divided into 12 sections based on the type of ideas. The ideas of effective conditions to continue working longer with the highest percentages were "better salary", followed by "more workers", and "easier to have holidays/private time".

Discussion
This study investigated the reasons for unwillingness to continue working for longer than five years to provide concrete ideas to reduce the turnover rate among preschool teachers in kindergartens, authorized childcare institutions, and nursery centers. The primary factors for unwillingness to continue working for longer than five years were overtime work, followed by low salary and human relations, which were consistent with the findings of previous research [5]. Additionally, the reasons for wanting to quit a job with the highest percentages were low salary, followed by too much overtime work/no payment for overtime and human relations, which were similar to the factors for unwillingness to continue working for longer than five years [5]. Preparation for events was indicated as the content at workplace with the highest percentage of responses, followed by administrative work and the extension of childcare/education. The contents at home with the highest percentages were administrative work, followed by preparation for events and making teaching materials. These results indicate that workers may have high levels of stress resulting from the need to work a lot, even in their private time, with low salaries in workplaces with difficult human relations.
To solve these issues, we asked the participants about their counterplan ideas. The results showed that the workshop ideas to solve job problems were related to "children's guardians", "taking care of children", "understanding children", "place to share suffering", "basic skills for work", "mental health", and "the way of working." In addition, the ideas of conditions most conducive to continue working longer were related to "employment conditions", "workforce", "workload", "human relations", "relationship with boss/seniors", "work environment", "welfare benefits", "duty framework", "taking care of children", "taking care of children's guardians", and "mental conditions." Integrating these ideas, we found common keywords for solving the problems: human relations (with children's guardians, children, boss, and colleagues, a place to share suffering), work conditions (salary, workforce, holidays, workload, and welfare benefits), and mental health. As such, the focus should be on a reward system, welfare benefits from the government or workplace, work conditions, human relations, and mental health. Additionally, preschool workers need places to share their suffering and learn to care for children and their guardians.
First, an analysis of work conditions suggested that a supportive work environment and better welfare benefits (e.g., flexible work options and paid maternal or paternal leave) and home telecommuting allowed them to continue working [8,9]. Similarly, efforts should be made to improve the conditions in both work-related and outside-work areas [10]. For example, Bhattacharya and Ramachandran reported that heavy workload-related pressures compel workers to leave work [11]; thus, supervisors should attempt to maintain the right workload balance [12].
Second, in terms of human relations, some studies have reported that challenging workplace relationships can lead to workplace stress across occupations and that providing counseling support for human relations can lead to better mental health [13][14][15][16][17]. Third, in terms of mental health, a survey indicated that a greater involvement in their work might reduce workers' stress and increase job satisfaction.
Finally, another study suggested that better government implementation of stress management plans could benefit the workers' psychosocial needs [18]. However, a randomized controlled trial found that nondirective social support focused on workers' intrapsychic challenges was significantly associated with fewer health problems [19][20][21][22]. Furthermore, nondirective social support, which focuses on workers' intrapsychic challenges, often improves positive health behavior, health outcomes, life satisfaction, self-esteem, hope, and optimism [20,21,23].
Hence, a better reward system (e.g., higher salary), welfare benefits (e.g., maternal leave) from the government or workplace, work conditions (e.g., less overtime work), human relations (e.g., compliments from the boss), and mental health (e.g., places to share suffering) affect their willingness to continue working. This study also has certain limitations. In particular, we recruited participants from one prefecture in Japan; therefore, the findings may not be generalizable across Japan or in other countries. Additionally, the study was limited in its ability to explore differences in responses across key demographic categories such as gender, age, experience in the field, etc., which must be considered in future research. Finally, future research should include participants from other prefectures and countries and attempt more specific questions suggested by the present research (e.g., letting the participants choose important workshop ideas from the given list). Despite these limitations, the findings provide meaningful new insights for addressing the shortage of preschool workers in childcare institutions.

Conclusions
The findings of this study suggest that the workshop ideas to solve job problems were related to children's guardians, taking care of children, understanding children, place to share suffering, basic skills for work, mental health, and the way of working. In addition, the ideas of conditions most conducive to continuing working longer were related to employment conditions, workforce, workload, human relations, relationship with boss/seniors, work environment, welfare benefits, duty framework, taking care of children, taking care of children's guardians, and mental conditions. As such, better reward systems, welfare benefits from the government or workplace, work conditions, human relations, and mental health can be key elements of counterplans to encourage preschool workers to continue working. In addition, these recommendations may assist in effectively addressing the high turnover rate among preschool workers in Japan. Informed Consent Statement: Informed consent was obtained from all participants prior to the study.

Data Availability Statement:
The datasets generated and analyzed during the current study are not publicly available due to a lack of participants' agreement to put the data in public but are available from the corresponding author on reasonable request.