Yang Chun, Wu Dehua, Yang Hong, Yin Huazhan, Wang Song
Department of Psychology, School of Education Science, Hunan Normal University, Changsha, 410081, China.
Mental Health Education and Counseling Center, Xiangtan University, Xiangtan, 411105, China.
BMC Nurs. 2025 Jul 1;24(1):743. doi: 10.1186/s12912-025-03445-7.
BACKGROUND: Nurses' turnover intention has long been a global concern due to its impact on the stability of the nursing workforce and the quality of healthcare services. Numerous studies have highlighted a strong relationship between psychological distress and turnover intention. However, very little is known about how psychological distress influences turnover intention among nurses. This study aims to explore the relationship between psychological distress and turnover intention, focusing on the mediation role of job satisfaction and the moderating role of social support among Chinese nurses. METHODS: A multicenter cross-sectional design was used. A total of 699 nurses were recruited from hospitals in two major cities of China (Chengdu and Kunming). Data regarding demographic information, Depression, Anxiety, and Stress Scale-21 (DASS-21), Job Satisfaction Index (JSI), Multidimensional Scale of Perceived Social Support (MSPSS), and Nurse Turnover Intention Scale (NTIS) were collected through online survey questionnaires. The moderated mediation model was tested via the PROCESS macro (Model 4 and Model 7) of SPSS 25.0. RESULTS: Psychological distress was negatively associated with turnover intention among nurses, and job satisfaction partially mediated this association. Social support moderated the association between psychological distress and job satisfaction, with the negative relationship between psychological distress and job satisfaction being stronger for nurses with higher levels of social support. As social support increased, the indirect effect of job satisfaction became stronger. CONCLUSION: Psychological distress increases the risk of turnover intention through decreasing nurses' job satisfaction, while social support moderates this mechanism. Healthcare organizations should prioritize strategies to reduce psychological distress and improve workplace satisfaction, particularly for nurses with high social support, ultimately promoting nurse retention and enhancing the quality of patient care. CLINICAL TRIAL NUMBER: Not applicable.
背景：护士离职意愿长期以来一直是全球关注的问题，因为它会影响护理人员队伍的稳定性和医疗服务质量。众多研究强调了心理困扰与离职意愿之间的紧密关系。然而，关于心理困扰如何影响护士离职意愿，人们知之甚少。本研究旨在探讨心理困扰与离职意愿之间的关系，重点关注工作满意度的中介作用以及社会支持在中国护士中的调节作用。 方法：采用多中心横断面设计。从中国两个主要城市（成都和昆明）的医院招募了699名护士。通过在线调查问卷收集了有关人口统计学信息、抑郁、焦虑和压力量表-21（DASS-21）、工作满意度指数（JSI）、感知社会支持多维量表（MSPSS）和护士离职意愿量表（NTIS）的数据。通过SPSS 25.0的PROCESS宏程序（模型4和模型7）对调节中介模型进行了检验。 结果：心理困扰与护士离职意愿呈负相关，工作满意度部分中介了这种关联。社会支持调节了心理困扰与工作满意度之间的关联，对于社会支持水平较高的护士，心理困扰与工作满意度之间的负相关更强。随着社会支持的增加，工作满意度的间接效应变得更强。 结论：心理困扰通过降低护士的工作满意度增加了离职意愿的风险，而社会支持调节了这一机制。医疗机构应优先采取策略减少心理困扰并提高工作场所满意度，特别是对于社会支持较高的护士，最终促进护士留任并提高患者护理质量。 临床试验编号：不适用。
Health Soc Care Deliv Res. 2024-12-18
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Psychol Res Behav Manag. 2024-5-31
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