Exploring the Role of Professional Burnout and Mental Health Strain in Nurses' Turnover Intentions: A Mediation Study

Nurses' turnover intentions had a significant challenge to healthcare systems worldwide. Burnout substantially contributes to turnover intentions and actual departure behavior, yet the underlying mechanisms remain underexplored.

To examine the mediating role of mental health strain in the relationship between professional burnout and nurses' turnover intentions.

This cross-sectional study employed a nonprobability, convenience sample of 234 registered nurses working at two tertiary hospitals in the Damietta Governorate, Egypt. Out of the 255 questionnaires distributed, 234 were returned, yielding a 91.8% response rate. Data were collected using self-reported questionnaires, including the Copenhagen Burnout Inventory (specifically work-related burnout subscale), the General Health Questionnaire, and the Turnover Intentions Scale, in addition to a demographic information form. Data were analyzed using descriptive and inferential statistics followed by Hayes' PROCESS Macro (Model 4) to conduct mediation analysis.

Professional burnout had a substantial positive direct influence on mental health strain (B = 0.221, p < 0.001) and turnover intentions (B = 0.589, p < 0.001). Mental health strain also substantially affected turnover intentions (B = 0.749, p < 0.001). Mediation analysis showed that mental health strain partially mediated the association between professional burnout and turnover intentions (B = 0.166; 95% CI [0.090-0.256]). Moreover, age (B = 0.067, p < 0.05) and experience (B = -0.078, p < 0.05) had a statistically significant influence on turnover intentions.

The findings highlight mental health strain as a crucial pathway through which professional burnout affects turnover intentions among nurses. Nursing managers should implement strategies to reduce professional burnout and support nurses' mental well-being to enhance retention and workforce stability. Additionally, health policymakers should consider implementing national standards for safe staffing, institutionalized mental health support programs, and long-term investments in workplace wellness to ensure a resilient and sustainable nursing workforce.