The role of bidirectional associations between depression, anxiety, and emotional exhaustion on turnover intention among nurses: a multicenter cross-sectional study in China

Abstract

Background A high turnover rate in nursing has become a global concern. Mental health issues may increase the turnover intention of nurses and lead to turnover behaviors. However, very little is known about the role of bidirectional associations between emotional exhaustion and depression/anxiety on turnover intention. This study aimed to examine the associations among depression, anxiety, emotional exhaustion and turnover intention, and to test the role of bidirectional associations between depression, anxiety, and emotional exhaustion on turnover intention among nurses. Methods An online multicenter cross-sectional study was conducted in Hunan Province, China, from December 2021 to February 2022. The questionnaire collected data from the Turnover Intention Scale, the Emotional Exhaustion Scale, the Patient Health Questionnaire-2, and the Generalized Anxiety Disorder Scale-2, as well as sociodemographic information. Data analysis was performed by univariate analysis, Pearson correlation analysis, multiple linear regression analysis, and structural equation modeling. Results The average turnover intention score among Chinese nurses was 14.34 ± 3.75. The prevalence of depression and anxiety was 25.9% and 22.3%, respectively. Depression (r = 0.378, P < 0.001), anxiety (r = 0.391, P < 0.001), and emotional exhaustion (r = 0.532, P < 0.001) were positively associated with turnover intention. Emotional exhaustion partially mediated the associations between depression/anxiety and turnover intention, with both mediating effects accounting for 60.7%. The mediating ratios of depression/anxiety on the associations between emotional exhaustion and turnover intentions were 17.6% and 16.5%, respectively. Conclusions Depression, anxiety, and emotional exhaustion showed significant positive effects on turnover intention among nurses. Emotional exhaustion played a partial mediation role between depression/anxiety and turnover intention, while depression/anxiety played no significant mediation role between emotional exhaustion and turnover intention.

Exploring the relationship between character strengths and well-being in nursing students: an analysis

“…This constant exposure can have adverse effects on their mental health, potentially leading to burnout (Jennings, 2008; Kesarwani et al , 2020). The toll of witnessing distressing scenarios and dealing with the demands of patient care can contribute to heightened stress, anxiety and even depression as has been observed in the preexisting literature (Kaushik et al , 2021; Gao et al , 2012; Qin et al , 2023). A study conducted on nursing students in Hong Kong found that factors such as financial challenges, sleep disturbances, absence of leisure activities and self-perceived poor mental health were noteworthy factors associated with depression, anxiety and stress experienced in the previous week (Cheung et al , 2016).…”