The impact of moral resilience on nurse turnover intentions: the mediating role of job burnout in a cross-sectional study.

High nursing staff turnover is a critical issue that negatively impacts the quality of care and patient safety. Turnover intentions, a key predictor of actual turnover, reflect an individual's likelihood of leaving their current position. Understanding the underlying mechanisms driving nurse turnover intentions is crucial for developing targeted interventions to stabilize the nursing workforce globally. This study aims to explore the relationship between moral resilience, job burnout, and turnover intentions among nurses, focusing on the mediating role of job burnout in this relationship. This study employed a quantitative, cross-sectional design. A convenience sample of 322 registered nurses was recruited from two tertiary hospitals in China between August and October 2023. Data were collected using the Chinese version of the Rushton Moral Resilience Scale (Chi-RMRS), the Maslach Burnout Inventory (MBI), and the Turnover Intention Scale. Data analyses were conducted using SPSS 26.0 and Amos 21.0. The study followed the STROBE guidelines for observational research. Before the commencement of data collection, the Institutional Review Board of Hunan Traditional Chinese Medical College (YXLL202401004) granted ethical approval. The proposed model exhibited an excellent fit to the data, with fit indices as follows: χ2/df = 1.819, CFI = 0.977, TLI = 0.961, RMSEA = 0.072 (90% confidence interval [CI]: 0.033 to 0.107). The structural equation model revealed that moral resilience was inversely associated with job burnout and turnover intentions. Furthermore, job burnout fully mediated the relationship between moral resilience and turnover intentions (β = -0.473, p = 0.007). Further analysis indicated that the depersonalization component of job burnout was the sole mediator in the relationship between moral resilience and turnover intention (β = -3.934, 95% CI [-5.837, -1.932]). The findings indicate that moral resilience among nurses is negatively associated with turnover intentions, with this effect fully mediated by the depersonalization dimension of job burnout. Enhancing moral resilience in nurses may be valuable strategy for healthcare administrators to mitigate job burnout and subsequently reduce turnover intentions.

Yi L ，Chen Z ，Jiménez-Herrera MF ，Gan X ，Ren Y ，Tian X ... -  《BMC NURSING》

Moral Resilience Reduces Levels of Quiet Quitting, Job Burnout, and Turnover Intention among Nurses: Evidence in the Post COVID-19 Era.

Galanis P ，Moisoglou I ，Katsiroumpa A ，Vraka I ，Siskou O ，Konstantakopoulou O ，Kaitelidou D ... -  《-》

The influence of frontline manager job strain on burnout, commitment and turnover intention: a cross-sectional study.

The frontline clinical manager role in healthcare is pivotal to the development of safe and healthy working conditions and optimal staff and patient care outcomes. However, in today's dynamic healthcare organizations managers face constant job demands from wider spans of control and complex role responsibilities but may not have adequate decisional authority to support effective work performance resulting in unnecessary job strain. Prolonged job strain can lead to burnout, health complaints, and increased turnover intention. Yet, there is limited research that examines frontline manager job strain and its impact on their well-being and work outcomes. The substantial cost associated with replacing experienced managers calls attention to the need to address job strain in order to retain this valuable organizational asset. Using Karasek's Job Demands-Control theory of job strain, a model was tested examining the effects of frontline manager job strain on their burnout (emotional exhaustion and cynicism), organizational commitment and ultimately, turnover intentions. Secondary analysis of data collected in an online cross-sectional survey of frontline managers was conducted using structural equation modeling. All 500 eligible frontline managers from 14 teaching hospitals in Ontario, Canada, were invited to participate and 159 responded for a 32% response rate. Participants received an email invitation with a secure link for the online survey. Ethics approval was obtained from the university ethics board and the respective ethics review boards of the 14 organizations involved in the study. The model was tested using path analysis techniques within structural equation modeling with maximum likelihood estimation. The final model fit the data acceptably (χ(2)=6.62, df=4, p=.16, IFI=99, CFI=.99, SRMR=.03, RMSEA=.06). Manager job strain was significantly positively associated with burnout which contributed to both lower organizational commitment and higher turnover intention. Organizational commitment was also negatively associated with turnover intention and there was an additional direct positive relationship between job strain and turnover intention. Preliminary support was found for a model showing that manager job strain contributes to burnout, reduced organizational commitment and higher turnover intentions. Findings suggest that organizations need to monitor and address manager job strain by ensuring managers' role demands are reasonable and that they have the requisite decision latitude to balance role demands.

Wong CA ，Spence Laschinger HK 《-》

The influence of areas of worklife fit and work-life interference on burnout and turnover intentions among new graduate nurses.

To examine the relationships among the overall person-job match in the six areas of worklife, work-life interference, new nurses' experiences of burnout and intentions to leave their jobs. As a large cohort of nurses approaches retirement, it is important to understand the aspects of the nurses work-life that are related to turnover among new graduate nurses to address the nursing workforce shortage. Secondary analysis of data collected in a cross-sectional survey of 215 registered nurses working in Ontario acute hospitals was conducted using structural equation modelling. The fit indices suggested a reasonably adequate fit of the data to the hypothesised model [χ(2)  = 247, d.f. = 122, P = 0.001, χ(2) /d.f. = 2.32, Incremental Fit Index (IFI) = 0.954, Comparative Fit Index (CFI) = 0.953, Root Mean Square Error of Approximation (RMSEA) = 0.06]. Person-job match in six areas of worklife had a direct negative effect on burnout (emotional exhaustion and cynicism), which in turn had a direct positive effect on turnover intentions. Work-life interference also influenced turnover intentions indirectly through burnout. The study findings demonstrate that new graduate nurses' turnover intentions are a recurring problem, which could be reduced by improving nurses' working conditions. Retention of new graduate nurses could be enhanced by creating supportive working environments to reduce the susceptibility to workplace burnout, and ultimately, lower turnover intentions. Managers must employ strategies to enhance workplace conditions that promote a person-job fit and work-life balance to improve retention of new graduate nurses, and, thereby, lessen the nursing shortage.

Boamah SA ，Laschinger H 《-》

Moral distress, moral resilience, and job embeddedness among pediatric nurses.

Li F ，Zhong J ，He Z 《-》