Nurses’ Intention to Leave the Organization: A Mediation Study of Professional Burnout and Engagement
Abstract
The nature of the turnover process calls for the study of more complex relationships among variables beyond simple bivariate or multiple associations between predictors and turnover intentions. The present article aims to examine the predictive value of job demands and resources in the explanation of nurses’ intention to leave the organization and to test the mediating roles of professional burnout and engagement in these relationships, within a Portuguese nursing population. The research models were tested within the scope of the Registered Nurse Forecasting project. Data included the self-report questionnaires of 2,235 Portuguese nurses from 31 hospitals, collected through stratified random sampling procedures. The statistical analyses of the structural models showed that nurses’ participation in hospital affairs, a job resource at the work organization level, was the only significant predictor of nurses´ intention to leave the organization (β=–.45,p< .001). Analyses of the mediation models revealed that the emotional exhaustion symptoms of burnout (β= –.11,p< .001) and job engagement feelings (β= –.15,p< .001) were both significant mediators between nurses’ decisional involvement and their intentions to leave the organization. Results suggest that including nurses in decision-making processes regarding their professional practice policy and environment, and improving nurses’ professional well-being are two crucial strategies to reduce nurses’ turnover intentions.
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Emotional Exhaustion mediates the relationship between nurses' participation in hospital affairs and their intention to leave the job.
“Emotional Exhaustion mediated the relationship between nurses’ participation in hospital affairs and their intention to leave the job [97]”
From Burnout in nursing: a theoretical review. (2020) · cites this paper as [97]
Emotional Exhaustion is a mediator between nurses' involvement with decisions and intention to leave the organisation.
“Emotional Exhaustion was a mediator between nurses’ involvement with decisions and intention to leave the organisation [97]”
From Burnout in nursing: a theoretical review. (2020) · cites this paper as [97]
Cites
Hu, L., & Bentler, P. M. (1999) · Structural Equation Modeling A Multidisciplinary Journal · doi:10.1080/10705519909540118 · Cited by 108,788 · see citing works
<b>lavaan</b> : An <i>R</i> Package for Structural Equation Modeling
Rosseel, Y. (2012) · Journal of Statistical Software · doi:10.18637/jss.v048.i02 · Cited by 27,955 · see citing works
Comparative fit indexes in structural models.
Bentler, P. M. (1990) · Psychological Bulletin · doi:10.1037/0033-2909.107.2.238 · Cited by 25,266 · see citing works
Job demands, job resources, and their relationship with burnout and engagement: a multi‐sample study
Schaufeli, W. B., & Bakker, A. B. (2004) · Journal of Organizational Behavior · doi:10.1002/job.248 · Cited by 9,297 · see citing works
To parcel or not to parcel: Exploring the question, weighing the merits
Little, T. D., Cunningham, W. A., Shahar, G., & Widaman, K. F. (2002) · Structural Equation Modeling: A Multidisciplinary Journal · doi:10.1207/s15328007sem0902_1 · Cited by 6,552 · see citing works
The World Health report 2006 1 : Working together for health 2
Guilbert, J.-J. (2006) · Education for Health · doi:10.1080/13576280600937911 · Cited by 2,657 · see citing works
Longitudinal Structural Equation Modeling
Little, T. D. (2013) · Cited by 2,604 · see citing works
Aiken, L. H., Sermeus, W., den Heede, K. V., Sloane, D. M., Busse, R., McKee, M., Bruyneel, L., Rafferty, A. M., Griffiths, P., Moreno‐Casbas, T., et al. (2012) · BMJ · doi:10.1136/bmj.e1717 · Cited by 2,060 · see citing works
The Truth about Burnout: How Organizations Cause Personal Stress and What to Do about It
Maslach, C., & Leiter, M. P. (1997) · Cited by 2,001 · see citing works
Sonnentag, S. (2003) · Journal of Applied Psychology · doi:10.1037/0021-9010.88.3.518 · Cited by 1,851 · see citing works
Development of the practice environment scale of the nursing work index†‡
Lake, E. T. (2002) · Research in Nursing & Health · doi:10.1002/nur.10032 · Cited by 1,769 · see citing works
The job demands–resources model: challenges for future research.
Demerouti, E., & Bakker, A. B. (2011) · SA Journal of Industrial Psychology · doi:10.4102/sajip.v37i2.974 · Cited by 1,426 · see citing works
Longitudinal Structural Equation Modeling
Geiser, C. (2014) · Springer eBooks · doi:10.1007/978-94-007-0753-5_1701 · Cited by 1,366 · see citing works
Angeles, L. (2002) · Cited by 1,182 · see citing works
One hundred years of employee turnover theory and research.
Hom, P. W., Lee, T., Shaw, J. D., & Hausknecht, J. P. (2017) · Journal of Applied Psychology · doi:10.1037/apl0000103 · Cited by 1,025 · see citing works
A Causal Model of Turnover for Nurses.
Price, J. L., & Mueller, C. W. (1981) · Academy of Management Journal · doi:10.2307/255574 · Cited by 1,000 · see citing works
semPLS: Structural Equation Modeling Using Partial Least Squares
Monecke, A., & Leisch, F. (2012) · Journal of Statistical Software · doi:10.18637/jss.v048.i03 · Cited by 658 · see citing works
COVARIANCE STRUCTURE ANALYSIS: Statistical Practice, Theory, and Directions
Bentler, P. M., & Dudgeon, P. (1996) · Annual Review of Psychology · doi:10.1146/annurev.psych.47.1.563 · Cited by 566 · see citing works
Heinen, M. M., van Achterberg, T., Schwendimann, R., Zander, B., Matthews, A., Kózka, M., Ensio, A., Sjetne, I. S., Moreno‐Casbas, T., Ball, J., et al. (2012) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2012.09.019 · Cited by 531 · see citing works
Job demands–resources, burnout and intention to leave the nursing profession: A questionnaire survey
Jourdain, G., & Chênevert, D. (2010) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2009.11.007 · Cited by 434 · see citing works
Poghosyan, L., Aiken, L. H., & Sloane, D. M. (2009) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2009.03.004 · Cited by 408 · see citing works
Nurse forecasting in Europe (RN4CAST): Rationale, design and methodology
Sermeus, W., Aiken, L. H., den Heede, K. V., Rafferty, A. M., Griffiths, P., Moreno‐Casbas, T., Busse, R., Lindqvist, R., Scott, P. A., Bruyneel, L., et al. (2011) · BMC Nursing · doi:10.1186/1472-6955-10-6 · Cited by 399 · see citing works
Bandalos, D. L. (2014) · Structural Equation Modeling: A Multidisciplinary Journal · doi:10.1080/10705511.2014.859510 · Cited by 381 · see citing works
Van Bogaert, P., Kowalski, C., Weeks, S. M., Van heusden, D., & Clarke, S. P. (2013) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2013.05.010 · Cited by 323 · see citing works
Nurses’ intention to leave the profession: integrative review
Flinkman, M., Leino‐Kilpi, H., & Salanterä, S. (2010) · Journal of Advanced Nursing · doi:10.1111/j.1365-2648.2010.05322.x · Cited by 321 · see citing works
Van Bogaert, P., Meulemans, H., Clarke, S., Vermeyen, K., & Van de Heyning, P. (2009) · Journal of Advanced Nursing · doi:10.1111/j.1365-2648.2009.05082.x · Cited by 194 · see citing works
Depersonalization: A Valid Dimension of Burnout?
Garden, A. (1987) · Human Relations · doi:10.1177/001872678704000901 · Cited by 111 · see citing works
Work environment issues and intention-to-leave in Portuguese nurses: A cross-sectional study
Leone, C., Bruyneel, L., Anderson, J. E., Murrells, T., Dussault, G., de Jesus, E. H., Sermeus, W., Aiken, L. H., & Rafferty, A. M. (2015) · Health Policy · doi:10.1016/j.healthpol.2015.09.006 · Cited by 90 · see citing works
Thirty Years of Nursing Turnover Research
Gilmartin, M. J. (2012) · Medical Care Research and Review · doi:10.1177/1077558712449056 · Cited by 85 · see citing works
A causal model for turnover for nurses.
Jl, P., & Cw, M. (1981) · PubMed · Cited by 68 · see citing works
Brewer, C. S., Chao, Y., Colder, C. R., Kovner, C. T., & Chacko, T. P. (2015) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2015.06.017 · Cited by 45 · see citing works
The Participation Of Nurses In Decision Making
Jaafarpour, M., & Jeihooni, A. K. (2011) · Research Repository Portal (Ilam University of Medical Sciences) · Cited by 14 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Burnout in nursing: a theoretical review.
Dall’Ora, C., Ball, J., Reinius, M., & Griffiths, P. (2020) · Human Resources for Health · doi:10.1186/s12960-020-00469-9 · Cited by 1,181 · see citing works
Relationship between nurse burnout, patient and organizational outcomes: Systematic review
Jun, J., Ojemeni, M. M., Kalamani, R., Tong, J., & Crecelius, M. L. (2021) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2021.103933 · Cited by 606 · see citing works
Cao, X., & Chen, L. (2021) · Journal of Nursing Management · doi:10.1111/jonm.13243 · Cited by 127 · see citing works
Burnout syndrome and work engagement in nursing staff: a systematic review and meta-analysis
Vargas-Benítez, M. Á., Izquierdo-Espín, F. J., Castro-Martínez, N., Gómez‐Urquiza, J. L., Albendín‐García, L., Velando‐Soriano, A., & la Fuente, G. A. C. (2023) · Frontiers in Medicine · doi:10.3389/fmed.2023.1125133 · Cited by 60 · see citing works
Sun, B., Fu, L., Yan, C., Wang, Y., & Fan, L. (2021) · Nurse Education in Practice · doi:10.1016/j.nepr.2021.103276 · Cited by 66 · see citing works
Nurses’ Well-Being at Work in a Hospital Setting: A Scoping Review
Almeida, D., Figueiredo, A. R., & Lucas, P. R. M. B. (2024) · Healthcare · doi:10.3390/healthcare12020173 · Cited by 50 · see citing works
Blanco‐Donoso, L. M., Moreno‐Jiménez, J. E., Hernández-Hurtado, M., Cifri-Gavela, J. L., Jacobs, S., & Garrosa, E. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18041932 · Cited by 45 · see citing works
Zhu, L., Wang, H., Xu, Y.-F., Ma, S.-T., & Luo, Y. (2023) · Journal of Nursing Management · doi:10.1155/2023/3356620 · Cited by 43 · see citing works
Zhang, F., Lin, C., Li, X., Li, M., Jia, R., Guo, X., & Bai, H. (2023) · Frontiers in Public Health · doi:10.3389/fpubh.2023.1216810 · Cited by 41 · see citing works
Impacts of Nursing Work Environment on Turnover Intentions: The Mediating Role of Burnout in Ghana
Poku, C. A., Donkor, E. S., & Naab, F. (2022) · Nursing Research and Practice · doi:10.1155/2022/1310508 · Cited by 54 · see citing works
Hu, H., Gong, H., Ma, D., & Wu, X. (2022) · PLoS ONE · doi:10.1371/journal.pone.0268939 · Cited by 35 · see citing works
Sasaki, N., Imamura, K., Tran, T. T. T., Nguyen, H. T., Kuribayashi, K., Sakuraya, A., Bui, T. M., Nguyen, Q. T., Nguyen, N. T., Nguyen, G. T. H., et al. (2021) · Journal of Medical Internet Research · doi:10.2196/20445 · Cited by 30 · see citing works
Nurses’ emotions on care relationship: A qualitative study
Font‐Jiménez, I., Ortega, L., Acebedo‐Uridales, M. S., Aguarón-García, M. J., Fernández, I. D. M., & Herrera, M. (2019) · Journal of Nursing Management · doi:10.1111/jonm.12934 · Cited by 28 · see citing works
Predictors of Burnout Among Physicians: Evidence From a National Study in Portugal
Pinto, A. M., Moreira, S., Costa‐Lopes, R., Zózimo, N., & Vala, J. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.699974 · Cited by 28 · see citing works
Organizational Commitment and Intention to Leave of Nurses in Portuguese Hospitals
Neves, T. M. A., Parreira, P., Rodrigues, V., & Graveto, J. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19042470 · Cited by 22 · see citing works
Workaholism, engagement and family interaction: Comparative study in portuguese and spanish nurses
Borges, E. M. D. N., Sequeira, C., Queirós, C. M. L., & Díaz, M. P. M. (2020) · Journal of Nursing Management · doi:10.1111/jonm.13213 · Cited by 19 · see citing works
Lucas, P. R. M. B., de Jesus, E. H., Almeida, S., Costa, P., Cruchinho, P. J. M., Teixeira, G. M., & Araújo, B. (2025) · Nursing Reports · doi:10.3390/nursrep15070224 · Cited by 17 · see citing works
Professional empowerment among Portuguese nursing staff: A correlational study
Teixeira, A. C., Nogueira, A., Nunes, J. R., Teixeira, L., & Barbieri‐Figueiredo, M. D. C. (2021) · Journal of Nursing Management · doi:10.1111/jonm.13250 · Cited by 14 · see citing works
Ford, J. L., Zhu, Y., & Barrett, A. K. (2021) · Communication Monographs · doi:10.1080/03637751.2021.1900886 · Cited by 14 · see citing works
Lesnik, T., & Hauser-Oppelmayer, A. (2025) · Human Resources for Health · doi:10.1186/s12960-025-00992-7 · Cited by 14 · see citing works
Liu, D., Zou, M., Ma, Y., Xie, Y., Zhang, W., Sun, C., Gao, Y., Shi, L., & Cui, Y. (2025) · Journal of Nursing Management · doi:10.1155/jonm/8839576 · Cited by 14 · see citing works
Entorno laboral saludable para la práctica asistencial de enfermería: revisión de literatura
Alfaro, B. S. P., & Bayer, G. L. A. (2022) · Revista Colombiana de Salud Ocupacional · doi:10.18041/2322-634x/rcso.1.2022.8290 · Cited by 7 · see citing works
Work engagement among new nurses in China: a latent profile analysis
Xiong, X., Huang, X., Shi, C., Xu, Z., & Rao, X. (2025) · BMJ Open · doi:10.1136/bmjopen-2024-087497 · Cited by 6 · see citing works
Impacts of nursing work environment and burnout on turnover intentions among nurses in GhanaPreprint
Poku, C. A., Donkor, E. S., & Naab, F. (2021) · Research Square · doi:10.21203/rs.3.rs-151653/v1 · Cited by 5 · see citing works
Well-Being Leadership Training to Reduce Clinician Burnout in a Metropolitan Community Health System
James, T. T., Nayak, A. C., Houff, A. M., Kantamneni, P. C., Li, H.-F., Scanlan, J. M., & Chun, L. L. M. W. (2025) · Healthcare · doi:10.3390/healthcare13233177 · Cited by 4 · see citing works
Cilluffo, S., Caruso, R., Bassola, B., Vellone, E., Pucciarelli, G., Terzoni, S., Ripari, C., & Lusignani, M. (2025) · Journal of Advanced Nursing · doi:10.1111/jan.70426 · Cited by 3 · see citing works
Kuribayashi, K., Inagaki, A., Imamura, K., & Kawakami, N. (2025) · BMJ Open · doi:10.1136/bmjopen-2024-085934 · Cited by 2 · see citing works
Karabey, T., & Aras, M. (2023) · Archives of Psychiatric Nursing · doi:10.1016/j.apnu.2023.04.010 · Cited by 1 · see citing works
Rubio, J. M. L., Pérez, J., Ruíz-Zorrilla, P., Sánchez, F. J. C., Canseco, A. F., & Navarro, J. I. V. (2024) · Preprints.org · doi:10.20944/preprints202401.0636.v1 · Cited by 1 · see citing works
Patient Retention, Nursing Retention: The Importance of Empathic Communication and Nursing Support
Domar, A. D. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108859486.012
PRÉ-NATAL NA ATENÇÃO BÁSICA DE SAÚDE
Carvalho, I. D. O., Lima, M. H. B., Lima, K. C., de Sousa, A. M. P., da Silva, G. M., de Queiroz, W. D. C. S., de Moraes, I. K. Q., Cardoso, B. D. O., de Oliveira, M. R., Pinto, J. G., et al. (2022) · doi:10.22533/at.ed.7262226089
Nazari, E., Roumi, A., & Sabooteh, T. (2024) · medRxiv · doi:10.1101/2024.11.12.24317140
Svobodová, H., & Bártlová, S. (2022) · Journal of Nursing Social Studies Public Health and Rehabilitation · doi:10.32725/jnss.2022.006
- Authors
- Marques-Pinto, A., Jesus, É. H., Mendes, A. M. O. C., Fronteira, I., & Roberto, M. S.
- Affiliations
- Universidade Nova de Lisboa (PT)
- University of Lisbon (PT)
- Venue
- The Spanish Journal of Psychology
- Publisher
- Cambridge University Press (CUP)
- Published
- 2018
- Volume
- 21
- Pages
- E32-E32
- ISSN
- 1138-7416 (ISSN-L)
- 1988-2904
- OpenAlex
- W2887197665
- Cited by
- 33
- References
- 32
- Citations by year
- 2025: 7 · 2024: 3 · 2023: 4 · 2022: 6 · 2021: 8 · 2020: 4 · 2019: 1
- FWCI
- 6.22
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Spanish Journal of Psychology (publishedVersion)
- PubMed (publishedVersion)
- Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion)
- Topics
- Health Sciences › Nursing › Research and Theory › Nursing education and management
- Health Sciences › Nursing › Leadership and Management › Healthcare Education and Workforce Issues
- Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Job Satisfaction and Organizational Behavior
- Keywords
- nurse turnover intention, professional burnout, work engagement, emotional exhaustion, job demands, job resources, professional well-being, Portuguese nurses
- MeSH terms
- Work Engagement, Adult, Burnout, Professional, Female, Humans, Male, Middle Aged, Nursing Staff, Hospital, Personnel Turnover, Portugal, Intention, Young Adult
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