The effect of burnout and its dimensions on turnover intention among nurses: A meta-analytic review
Corresponding Author
Ahmet Hakan Özkan PhD
Assistant Professor
International Trade and Finance, Faculty of Economics, Administrative and Social Sciences, Istanbul Gedik University, Istanbul, Turkey
Correspondence
Ahmet Hakan Özkan, International Trade and Finance, Faculty of Economics, Administrative and Social Sciences, Istanbul Gedik University, Istanbul, Turkey.
Email: [email protected]; [email protected]
Search for more papers by this authorCorresponding Author
Ahmet Hakan Özkan PhD
Assistant Professor
International Trade and Finance, Faculty of Economics, Administrative and Social Sciences, Istanbul Gedik University, Istanbul, Turkey
Correspondence
Ahmet Hakan Özkan, International Trade and Finance, Faculty of Economics, Administrative and Social Sciences, Istanbul Gedik University, Istanbul, Turkey.
Email: [email protected]; [email protected]
Search for more papers by this authorAbstract
Aim
The objective of this study is elaborating on the relationship between burnout and turnover intention.
Background
Burnout and its dimensions have a significant effect on turnover intention.
Evaluation
Meta-analysis technique is used. Forty-four studies were brought together to form four data sets. These data sets were heterogeneous, and they did not include publication bias. The effect sizes of burnout, emotional exhaustion, depersonalization and professional efficacy on turnover intention among nurses were computed.
Key Issues
Random-effects model was used. The groups including two or more studies were added into moderator analysis.
Conclusions
The effect size of the relationship between professional efficacy and turnover intention was small, and the effect size of the other surveyed reationships was medium among both nurses and other health employees. The moderator analysis results suggested that the effect size of the relationship between professional efficacy and turnover intention among nurses is significantly different from the other health employees. Being a nurse was determined as a significant moderator for the relationship between professional inefficacy and turnover intention, and it weakened this relationship.
Implications for Nursing Management
The findings of this study can be used by health managers as burnout and turnover intention are important to determine organizational policies.
CONFLICT OF INTEREST
There is no conflict of interest to be declared.
Open Research
DATA AVAILABILITY STATEMENT
Author does not wish to share the data.
REFERENCES
- Acker, G. M. (2010). The influence of managed care on job-related attitudes of social workers. Social Work in Mental Health, 8(2), 174–189. https://doi.org/10.1080/00981380902765378
10.1080/00981380902765378 Google Scholar
- Angermeier, I. (2009). The impact of participative management perceptions on customer service, medical errors, burnout, and turnover intentions. Journal of Healthcare Management, 54(2), 127–141. https://doi.org/10.1097/00115514-200903000-00011
- Back, C., Hyun, D., Jeung, D., & Chang, S. (2020). Mediating effects of burnout in the association between emotional labor and turnover intention in Korean clinical nurses. Safety and Health at Work, 11(1), 88–96. https://doi.org/10.1016/j.shaw.2020.01.002
- Bobbio, A., & Manganelli, A. M. (2015). Antecedents of hospital nurses' intention to leave the organization: A cross sectional survey. International Journal of Nursing Studies, 52, 1180–1192. https://doi.org/10.1016/j.ijnurstu.2015.03.009
- Bria, M., Baban, A., Andreica, S., & Dumitraşcu, D. L. (2013). Burnout and turnover intentions among Romanian ambulance. Personnel. Procedia - Social and Behavioral Sciences, 84, 801–805. https://doi.org/10.1016/j.sbspro.2013.06.650
10.1016/j.sbspro.2013.06.650 Google Scholar
- Cheng, C., Bartram, T., Karimi, L., & Leggat, S. (2016). Transformational leadership and social identity as predictors of team climate, perceived quality of care, burnout and turnover intention among nurses. Personnel Review, 45(6), 1200–1216. https://doi.org/10.1108/pr-05-2015-0118
- Choi, M. Y., So, H. S., & Ko, E. (2019). Influences of occupational stress, ethical dilemma, and burnout on turnover intention in hospital nurses. Journal of Korean Academy of Fundamentals of Nursing, 26(1), 42–51. https://doi.org/10.7739/jkafn.2019.26.1.42 (In Korean)
10.7739/jkafn.2019.26.1.42 Google Scholar
- Chullen, C. L. (2018). Should I stay or should I go now: Nurse burnout & turnover intentions. SAM Advanced Management Journal, 83(3), 45–60. https://doi.org/10.12968/bjon.2016.25.17.990
- Cohen, J. (1988). Statistical power analysis for the behavioral sciences ( 2nd ed.). Lawrence Earlbaum Associates.
10.1046/j.1526-4610.2001.111006343.x Google Scholar
- Diehl, E., Rieger, S., Letzel, S., Schablon, A., Nienhaus, A., Escobar Pinzon, L. C., & Dietz, P. (2021). The erlationship between workload and burnout among nurses: The buffering role of personal, social and organisational resources. PLoS ONE, 16(1), e0245798. https://doi.org/10.1371/journal.pone.0245798
- Egger, M., Davey-Smith, G., Schneider, M., & Minder, C. (1997). Bias in meta-analysis detected by a simple, graphical test. British Medical Journal, 315, 629–634. https://doi.org/10.1136/bmj.315.7109.629
- Elci, M., Yildiz, B., & Karabay, M. E. (2018). How burnout affects turnover intention? The conditional effects of subjective vitality and supervisor support. International Journal of Organizational Leadership, 7, 47–60. https://doi.org/10.33844/ijol.2018.60233
- Fu, C., Wang, G., Shi, X., Ren, Y., & Cao, F. (2021). The association between fear of future workplace violence and burnout among nurses in China: A cross-sectional study. Journal of Affective Disorders, 293, 29–35. https://doi.org/10.1016/j.jad.2021.06.013
- Gowda, M. N. (1996). Factors associated with burnout and turnover intention among case managers who work with older adults. Doctoral dissertation. Graduate School of The Ohio State University.
- Green, A. E., Miller, E. A., & Aarons, G. A. (2013). Transformational leadership moderates the relationship between emotional exhaustion and turnover intention among community mental health providers. Community Mental Health Journal, 49, 373–379. https://doi.org/10.1007/s10597-011-9463-0
- Han, S. J., Bonn, M. A., & Cho, M. (2016). The relationship between customer incivility, restaurant frontline service employee burnout and turnover intention. International Journal of Hospitality Management, 52, 97–106. https://doi.org/10.1016/j.ijhm.2015.10.002
- Hong, E., & Lee, Y. S. (2016). The mediating effect of emotional intelligence between labour, job stres, burnout and nurses' turnover intention. International Journal of Nursing Practice, 22, 625–632. https://doi.org/10.1111/ijn.12493
- Janssen, P. P. M., Longe, J., & Bakker, A. B. (1999). Specific determinants of intrinsic work motivation, burnout and turnover intentions: A study among nurses. Journal of Advanced Nursing, 29(6), 1360–1369. https://doi.org/10.1046/j.1365-2648.1999.01022.x
- Jourdain, G., & Chenevert, D. (2010). Job demands–resources, burnout and intention to leave the nursing profession: A questionnaire survey. International Journal of Nursing Studies, 47, 709–722. https://doi.org/10.1016/j.ijnurstu.2009.11.007
- Kim, H., & Kao, D. (2014). A meta-analysis of turnover intention predictors among U.S. child welfare workers. Children and Youth Services Review, 47(3), 214–223. https://doi.org/10.1016/j.childyouth.2014.09.015
- Kim, H., & Lee, S. Y. (2009). Supervisory communication, burnout, and turnover intention among social workers in health care settings. Social Work in Health Care, 48(4), 364–385. https://doi.org/10.1080/00981380802598499
- Kim, H., & Stoner, M. (2008). Burnout and turnover intention among social workers: Effects of role stress, job autonomy and social support. Administration in Social Work, 32(3), 5–2. https://doi.org/10.1080/03643100801922357
- Kim, Y., Lee, E., & Lee, H. (2019). Association between workplace bullying and burnout, professional quality of life, and turnover intention among clinical nurses. PLoS ONE, 14(12), e0226506. https://doi.org/10.1371/journal.pone.0226506
- Laeeque, S. H., Bilal, A., Babar, S., Khan, Z., & Rahman, U. S. (2018). How patient-perpetrated workplace violence leads to turnover intention among nurses: The mediating mechanism of occupational stress and burnout. Journal of Aggression, Maltreatment & Trauma, 27(1), 96–118. https://doi.org/10.1080/10926771.2017.1410751
- Laschinger, H. K. S. (2012). Job and career satisfaction and turnover intentions of newly graduated nurses. Journal of Nursing Management, 20, 472–484. https://doi.org/10.1111/j.1365-2834.2011.01293.x
- Laschinger, H. K. S., & Fida, R. (2014). A time-lagged analysis of the effect of authentic leadership on workplace bullying, burnout, and occupational turnover intentions. European Journal of Work and Organizational Psychology, 23(5), 739–753. https://doi.org/10.1080/1359432X.2013.804646
- Lee, S. E., MacPhee, M., & Dahinten, V. S. (2020). Factors related to perioperative nurses' job satisfaction and intention to leave. Japan Journal of Nursing Science, 17. https://doi.org/10.1111/jjns.12263
- Lei, J., Luo, M., Chui, E., & Lu, W. (2019). Whether professional training matters: Attitudinal antecedents to the turnover intentions of social workers in Guangzhou, China. Journal of Social Service Research, 45(3), 444–454. https://doi.org/10.1080/01488376.2018.1480569
- Liu, W., Zhao, S., Shi, L., Zhang, Z., Liu, X., Li, L., Duan, X., Li, X., Lou, F., Jia, X., Fan, L., Sun, T., & Ni, X. (2018). Workplace violence, job satisfaction, burnout, perceived organisational support and their effects on turnover intention among Chinese nurses in tertiary hospitals: A crosssectional study. BMJ Open, 8(6), 11. https://doi.org/10.1136/bmjopen-2017-019525
- Mahfooz, Z., Nisar, Q. A., & Azeem, M. (2017). Does workplace incivility & workplace ostracism influence the employees' turnover intentions? Mediating role of burnout and job stress & moderating role of psychological capital. International Journal of Academic Research in Business and Social Sciences, 7(8), 398–413. https://doi.org/10.6007/IJARBSS/V7-I8/3244
10.6007/IJARBSS/v7-i8/3244 Google Scholar
- Mahoney, C. B., Lea, J., Schumann, P. L., & Jilson, I. A. (2020). Turnover, burnout, and job satisfaction of certified registered nurse anesthetists in the United States: Role of job characteristics and personality. AANA Journal, 88(1), 39–48.
- McDowell, S. S. (2015). Client-inflicted workplace violence, burnout, job satisfaction, and turnover intention: A comparative analysis between institution-based and home-based direct care paraprofessionals. Doctoral dissertation:. Howard University.
- Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Annals of Internal Medicine, 151(4), 264–269. https://doi.org/10.1371/journal.pmed.1000097
- Na, S. Y., & Park, H. (2019). The effect of nurse's emotional labor on turnover intention: Mediation effect of burnout and moderated mediation effect of authentic leadership. Journal of Korean Academy of Nursing, 49(3), 286–297. https://doi.org/10.4040/jkan.2019.49.3.286
- Park, J., & Min, H. (2020). Turnover intention in the hospitality industry: A meta-analysis. International Journal of Hospitality Management, 90. https://doi.org/10.1016/j.ijhm.2020.102599
- Roczniewska, M., & Bakker, A. B. (2021). Burnout and self-regulation failure: A diary study of self-undermining and job crafting among nurses. Journal of Advanced Nursing, 77(8), 3424–3435. https://doi.org/10.1111/jan.14872
- Roth, C., Berger, S., Krug, K., Mahler, C., & Wensing, M. (2021). Internationally trained nurses and host nurses' perceptions of safety culture, work-life-balance, burnout, and job demand during workplace integration: A cross-sectional study. BMC Nursing, 20(77). https://doi.org/10.1186/s12912-021-00581-8
- Sabei, S. D., Labrague, L. J., Ross, A. M., Karkada, S., Albashayreh, A., Al Masroori, F., & Al Hashmi, N. (2020). Nursing work environment, turnover intention, job burnout, and quality of care: The moderating role of job satisfaction. Journal of Nursing Scholarship, 52(1), 95–104. https://doi.org/10.1111/jnu.12528
- Scanlan, J. N., Meredith, P., & Poulsen, A. A. (2013). Enhancing retention of occupational therapists working in mental health: Relationships between wellbeing at work and turnover intention. Australian Occupational Therapy Journal, 60, 395–403. https://doi.org/10.1111/1440-1630.12074
- Shao, J., Tang, L., Wang, X., Qiu, R., Zhang, Y., Jia, Y., Ma, Y., & Ye, Z. (2018). Nursing work environment, value congruence and their relationships with nurses' work outcomes. Journal of Nursing Management, 26, 1091–1099. https://doi.org/10.1111/jonm.12641
- Shemueli, R. G., Dolan, S. L., Ceretti, A. S., & Prado, P. N. (2016). Burnout and engagement as mediators in the relationship between work characteristics and turnover intentions across two Ibero-American nations. Stress and Health, 32(5), 597–606. https://doi.org/10.1002/smi.2667
- Song, K. (2005). Prevalence of client violence toward child & family social workers and its effects on burnout, organizational commitment, and turnover intention: A structural equation modeling approach. Doctoral thesis. USA.
- Takase, M., Teraoka, S., & Kousuke, Y. (2014). Investigating the adequacy of the competence-turnover intention model: How does nursing competence affect nurses' turnover intention? Journal of Clinical Nursing, 24, 805–816. https://doi.org/10.1111/jocn.12711
- Tang, G., Ren, S., Chadee, D., & Yuan, S. (2019). The dark side of social media connectivity influence on turnover intentions of supply chain professionals. International Journal of Operations & Production Management, 40, 603–623. https://doi.org/10.1108/IJOPM-05-2019-0391
- Tsukamoto, N., Kudo, M., Katagiri, Y., Watanabe, A., Funaki, Y., & Hirata, A. (2021). Differences in the effects of organisational climate on burnout according to nurses' level of experience. Journal of Nursing Management, 29(2), 194–205. https://doi.org/10.1111/jonm.13137
- Tziner, A., Rabenu, E., Radomski, R., & Belkin, A. (2015). Work stress and turnover intentions among hospital physicians: The mediating role of burnout and work satisfaction. Journal of Work and Organizational Psychology, 31, 207–213. https://doi.org/10.1016/j.rpto.2015.05.001
- Wang, E., Hu, H., Mao, S., & Liu, H. (2019). Intrinsic motivation and turnover intention among geriatric nurses employed in nursing homes: The roles of job burnout and pay satisfaction. Contemporary Nurse, 55(2–3), 195–210. https://doi.org/10.1080/10376178.2019.1641120
- Wang, H., Jin, Y., Wang, D., Zhao, S., Sang, X., & Yuan, B. (2020). Job satisfaction, burnout, and turnover intention among primary care providers in rural China: Results from structural equation modeling. BMC Family Practice, 21, 12–22. https://doi.org/10.1186/s12875-020-1083-8
- Wang, T. (2019). ICU nurses' burnout, organizational commitment, turnover intention and hospital workplace violence- study in Sichuan Province, China. Master's Thesis. Lisboa University.
- Wang, Z., Liu, H., Yu, H., Wu, Y., Chang, S., & Wang, L. (2017). Associations between occupational stress, burnout and well-being among manufacturing workers: Mediating roles of psychological capital and self-esteem. BMC Psychiatry, 17(1), 364. https://doi.org/10.1186/s12888-017-1533-6
- Wong, C. A., & Laschinger, H. K. S. (2015). The influence of frontline manager job strain on burnout, commitment and turnover intention: A cross-sectional study. International Journal of Nursing Studies, 52, 1824–1833. https://doi.org/10.1016/j.ijnurstu.2015.09.006
- Wu, X., Hayter, M., Lee, A. J., Yuan, Y., Li, S., Bi, Y., Zhang, L., Cao, C., Gong, W., & Zhang, Y. (2020). Positive spiritual climate supports transformational leadership as means to reduce nursing burnout and intent to leave. Journal of Nursing Management, 10 pages, 804–813. https://doi.org/10.1111/jonm.12994
- Yang, Y., & Chen, J. (2020). Related factors of turnover intention among pediatric nurses in mainland China: A structural equation modeling analysis. Journal of Pediatric Nursing, e217–e223. https://doi.org/10.1016/j.pedn.2020.04.018
- Yildiz, B., Ensari, M. S., Elci, M., & Karabay, M. E. (2019). İş-aile çatışmasının işten ayrılma niyeti üzerindeki etkisinde tükenmişliğin aracı etkisi. [the m ediating effect of burnout on the relationship between work-family conflict and turnover intention]. The Journal of Human and Work, 6(1), 13–27. https://doi.org/10.18394/iid.448547 (In Turkish)
- Yu, M., & Lee, H. (2018). Impact of resilience and job involvement on turnover intention of new graduate nurses using structural equation modeling. Japan Journal of Nursing Science, 15, 351–362. https://doi.org/10.1111/jjns.12210
- Zangaro, G. A., & Soeken, K. L. (2007). A meta-analysis of studies of nurses' job satisfaction. Research in Nursing & Health, 30(4), 445–458. https://doi.org/10.1002/nur.20202