Top

BMC Public Health

Published in:

Open Access 01-12-2024 | Research

Effects of perceived stress on turnover intention of female healthcare staff: a serial multiple mediation model

Authors: Dongling Yuan, Muli Hu, Na Yao, Huiyuan Zhong, Yinghong Xiao, Xiao Zhou, Ruoyi Zhang, Yi Zhang

Published in: BMC Public Health | Issue 1/2024

Abstract

Background

Healthcare staff in China, especially females, work in a high-pressure, high-load, and high-risk environment, which affects the physical and mental health, the efficiency and quality of work, and increases turnover intention. The present study investigated the relationship between perceived stress and turnover intention in female healthcare staff, and the effects of future-oriented coping and work-family balance on this relationship.

Methods

Four hundred thirty-five female medical workers were recruited to perform a perceived stress scale, future-oriented coping inventory, work-family balance scale and turnover intention scale. Meanwhile, serial multiple mediation analysis was performed using PROCESS.

Results

1) Perceived stress positively predicted the level of turnover intention in female healthcare staff; 2) Preventive coping and proactive coping showed mediation effects on the relationship between perceived stress and turnover intention, and preventive coping positively related to proactive coping; 3) The work-family balance also showed mediation effects on the relationship between perceived stress and turnover intention; 4) Preventive coping, proactive coping and work-family balance showed a serial multiple mediation on the relationship between perceived stress and turnover intention in female healthcare workers.

Conclusions

Perceived stress affects the level of turnover intention in female healthcare staff through preventive coping, proactive coping, and work-family balance. In addition, the sequential model of future-oriented coping was validated among female healthcare staff.

Baptista S, Teixeira A, Castro L, Cunha M, Serrão C, Rodrigues A, et al. Physician burnout in primary care during the COVID-19 Pandemic: a cross-sectional study in portugal. J Prim Care Community Health. 2021;12:21501327211008436.CrossRefPubMedPubMedCentral

Tao SY, Liu W, Hao YH, Song WJ, Xue YX, Wang JH, et al. Analysis of the current situation of clinicians’ willingness to leave in four tertiary hospitals in western Heilongjiang Province. Chinese Hospitals. 2020;24(6):35–7.

Wang Y, Yuan H. What is behind high turnover: a questionnaire survey of hospital nursing care workers in shanghai, China. BMC Health Serv Res. 2018;18(1):485.CrossRefPubMedPubMedCentral

Peltokorpi V, Allen DG, Froese F. Organizational embeddedness, turnover intentions, and voluntary turnover: the moderating effects of employee demographic characteristics and value orientations. J Organ Behav. 2015;36(2):292–312.CrossRef

Huang TL, Wong MK, Shyu YIL, Ho LH, Yeh JR, Teng CI. Reducing turnover intention to improve care outcome: a two-wave study. J Adv Nurs. 2021;77(7):3083–92.CrossRefPubMed

Holland P, Tham TL, Sheehan C, Cooper B. The impact of perceived workload on nurse satisfaction with work-life balance and intention to leave the occupation. Appl Nurs Res ANR. 2019;49:70–6.CrossRefPubMed

Grant S, Davidson J, Manges K, Dermenchyan A, Wilson E, Dowdell E. Creating healthful work environments to deliver on the quadruple aim: a call to action. J Nurs Adm. 2020;50(6):314–21.CrossRefPubMed

Morens DM, Daszak P, Markel H, Taubenberger JK. Pandemic COVID-19 joins history’s pandemic legion. mBio. 2020;11(3):e00812-20.CrossRefPubMedPubMedCentral

Nazir T, Umer M, Najam M, Nawab S, Maqsoom A, Shafi K, et al. Impact role stress on turnover intentions of pakistan’s healthcare workers: Mediating and moderating role of organizational cynicism and self-efficacy. PLoS ONE. 2022;17(12):e0279075.CrossRefPubMedPubMedCentral

10.

Bohlken J, Schömig F, Lemke MR, Pumberger M, Riedel-Heller SG. COVID-19 pandemic: stress experience of healthcare workers - a short current review. Psychiatr Prax. 2020;47(4):190–7.PubMedPubMedCentral

11.

Heponiemi T, Presseau J, Elovainio M. On-call work and physicians’ turnover intention: the moderating effect of job strain. Psychol Health Med. 2016;21(1):74–80.CrossRefPubMed

12.

Folkman S, Lazarus RS, Gruen RJ, Delongis A. Appraisal, coping, health status, and psychological symptoms. J Pers Soc Psychol. 1986;50(3):571–9.CrossRefPubMed

13.

Xiong SC, Xu Y, Zhang B, Zhu LF, Su ZF. The relationship between acute stress and nurses’ work withdrawal under major public health events: a mediated model with moderation. Chin J Clin Psychol. 2021;29(2):277–81.

14.

Schwarzer R. Tenacious Goal Pursuits and Striving Toward Personal Growth: Proactive Coping. 2002; Available from: http://doc.paperpass.com/foreign/rgArti2002141584705.html. Cited 2023 May 6.

15.

Miao M, Wang YQ, Ye Q, Ke Q, Gan YQ. alidation of a sequential model of future-oriented coping in prospective newlywed individuals. Chinese J Clin Psychol. 2017;25(4):678–83+696.

16.

Gan Y, Yang M, Yan Z, Zhang Y. The two-factor structure of future-oriented coping and its mediating role in student engagement. Personal Individ Differ. 2007;43(4):851–63.CrossRef

17.

Hu H, Wang C, Lan Y, Wu X. Nurses’ turnover intention, hope and career identity: the mediating role of job satisfaction. BMC Nurs. 2022;10(21):43.CrossRef

18.

Gan YQ. A two-stage sequential model of future-oriented coping and its time-perspective mechanism. Adv Psycholog Sci. 2011;19(11):1583–7.

19.

Wu Y-F, Wang P-C, Chen Y-C. Gender differences and work-family conflicts among emergency physicians with intention to leave. Emerg Med Int. 2018;2018:3919147.CrossRefPubMedPubMedCentral

20.

Pappa S, Ntella V, Giannakas T, Giannakoulis VG, Papoutsi E, Katsaounou P. Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: a systematic review and meta-analysis. Brain Behav Immun. 2020;1(88):901–7.CrossRef

21.

Gold KJ, Kuznia AL, Laurie AR, Williams CB. Gender differences in stress and burnout: department survey of academic family physicians. J Gen Intern Med. 2021;36(6):1811–3.CrossRefPubMed

22.

José Aurelio Medina-Garrido, José María Biedma-Ferrer, María Vanessa Rodríguez-Cornejo. I Quit! Effects of Work-Family Policies on the Turnover Intention. Int. J. Environ. Res. Public. Health. 2021;(4). Available from: http://pubmed.ncbi.nlm.nih.gov/33669281/. Cited 2023 May 6.

23.

Macdermid M. Multiple roles and the self: a theory of role balance. J Marriage Fam. 1996;58(2):417–32.CrossRef

24.

Grzywacz JG, Carlson DS. conceptualizing work—family balance: implications for practice and research. Adv Dev Hum Resour SAGE Pub. 2007;9(4):455–71.CrossRef

25.

Peltokorpi V, Cieply I, Froese FJ. Woman’s work: The moderating effects of gender role orientations between the relationships of work-family conflict with voluntary turnover and being valued by one’s spouse. Int J. Psychol. 2023 Dec 1.

26.

Grandey AA, Cropanzano R. The conservation of resources model applied to work-family conflict and strain. J Vocat Behav. 1999;54(2):350–70.CrossRef

27.

Barnett MD, Martin KJ, Garza CJ. Satisfaction With Work–Family Balance Mediates the Relationship Between Workplace Social Support and Depression Among Hospice Nurses. J. Nurs. Scholarsh. 2019;51. Available from: http://pubmed.ncbi.nlm.nih.gov/30570211/. Cited 2023 May 6.

28.

Phillips C. Relationships between workload perception, burnout, and intent to leave among medical-surgical nurses. Int J Evid Based Healthc. 2020;18(2):265–73.CrossRefPubMed

29.

Labrague LJ, McEnroe-Petitte DM, Gloe D, Tsaras K, Arteche DL, Maldia F. Organizational politics, nurses’ stress, burnout levels, turnover intention and job satisfaction. Int Nurs Rev. 2017;64(1):109–16.CrossRefPubMed

30.

Yang T, Jin X, Shi H, Liu Y, Guo Y, Gao Y, et al. Occupational stress, distributive justice and turnover intention among public hospital nurses in China: a cross-sectional study. Appl Nurs Res ANR. 2021;61:151481.CrossRefPubMed

31.

Cohen S. Perceived stress in a probability sample of the United States. Soc. Psychol. Health . Thousand Oaks, CA, US: Sage Publications, Inc; 1988. p. 31–67.

32.

Lin XY, Wang YL, Hao YJ, Li HJ. A study on the mechanism of the influence of leader-member exchange on work-family balance: The mediating role of work flexibility ability and the moderating role of work flexibility intention. Manage Rev. 2016;28(2):138–48.

33.

Greenglass E, Schwarzer R, Jakubiec D, Fiksenbaum L, Taubert S. The Proactive Coping Inventory (PCI): A Theory-Guided Multidimensional Instrument. 1999; Available from: http://www.nuokui.com/doc/sBp35MG2crjI.html. Cited 2023 May 6.

34.

Scott CR, Connaughton SL, Diaz-Saenz HR, Maguire K, Ramirez R, Richardson B, et al. The Impacts of communication and multiple identifications on intent to leave: a multimethodological exploration. Manag Commun Q. 1999;12(3):400–35 SAGE Publications Inc.CrossRef

35.

Zhonglin W, Kit-Tai H, Marsh HW. Structural equation model testing: cutoff criteria for goodness of fit indices and chi-square test. Acta Psychol Sin. 2004;36(02):186.

36.

Igartua JJ, Hayes AF. Mediation, moderation, and conditional process analysis: concepts, computations, and some common confusions. Span J Psychol. 2021;24:e49.CrossRefPubMed

37.

Malhotra NK, Kim SS, Patil A. Common Method Variance in IS Research: A Comparison of Alternative Approaches and a Reanalysis of Past Research. Manag. Ence. 2006;52. Available from: http://econpapers.repec.org/article/inmormnsc/v_3a52_3ay_3a2006_3ai_3a12_3ap_3a1865-1883.htm. Cited 2023 May 6.

38.

Labrague LJ, de Los Santos JAA. Fear of COVID-19, psychological distress, work satisfaction and turnover intention among frontline nurses. J Nurs Manag. 2021;29(3):395–403.CrossRefPubMed

39.

Ramírez-Elvira S, Romero-Béjar JL, Suleiman-Martos N, Gómez-Urquiza JL, Monsalve-Reyes C, Cañadas-De la fuente GA, et al. Prevalence, risk factors and burnout levels in intensive care unit nurses: a systematic review and meta-analysis. Int J Environ Res Public Health. 2021;18(21):11432.CrossRefPubMedPubMedCentral

40.

Schutz V, Shattell M. Impact of COVID-19: What Does It Mean For Nurses and Health Systems? J. Psychosoc. Nurs. Ment. Health Serv. 2020;(8). Available from: http://pubmed.ncbi.nlm.nih.gov/32744640/. Cited 2023 May 6.

41.

Caperelli Gergel MC, Terry DL. Giving 200%: workplace flexibility and provider distress among female physicians. J Healthc Leadersh. 2022;14:83–9.CrossRefPubMedPubMedCentral

42.

Biaczyk K, Wyszkowska Z, Maciej Bieliński. Affective Temperament is Associated with Stress Coping Strategies and Work Stress Perception Among Polish Bank Employees. Psychol. Res. Behav. Manag. 2020; Available from: http://pubmed.ncbi.nlm.nih.gov/33414647/. Cited 2023 May 6.

43.

Yang BY, Su SQ. The relationship between family role identity and work engagement: a mediated model with moderation. Chin J Clin Psychol. 2022;30(1):134–8.

44.

Tselebis A, Lekka D, Sikaras C, Tsomaka E, Pachi A. Insomnia, perceived stress, and family support among nursing staff during the pandemic crisis. Healthcare. 2020;8(4):434.CrossRefPubMedPubMedCentral

45.

Green-Laughlin DL. COVID-19: a closer lens. Issues Ment Health Nurs. 2020;41(1):1–3.

Title: Effects of perceived stress on turnover intention of female healthcare staff: a serial multiple mediation model
Authors: Dongling Yuan
Muli Hu
Na Yao
Huiyuan Zhong
Yinghong Xiao
Xiao Zhou
Ruoyi Zhang
Yi Zhang
Publication date: 01-12-2024
Publisher: BioMed Central
Published in: BMC Public Health / Issue 1/2024
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-024-18654-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Effects of perceived stress on turnover intention of female healthcare staff: a serial multiple mediation model

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2024

Sex differences and dietary patterns in the association of air pollutants and hypertension

Sodium, potassium intake, and all-cause mortality: confusion and new findings

The quality of life of men experiencing infertility: a systematic review

Subnational estimates of life expectancy at birth in India: evidence from NFHS and SRS data

The global, regional, and national burden of foreign bodies from 1990 to 2019: a systematic analysis of the global burden of disease study 2019

Research highlight: cultivating community-based participatory research (CBPR) to respond to the COVID-19 pandemic: an illustrative example of partnership and topic prioritization in the food services industry