Work-Family Conflict and Turnover Intention Among Chinese Nurses: The Serial Mediating Roles of Career Identity and...

High turnover intention among nurses is a major threat to the stability of the nursing workforce in China. Work-family conflict is a salient job demand that may be associated with nurses' career identity, work engagement and intention to leave, but the relationships among these constructs remain insufficiently understood.

To examine the association between work-family conflict and turnover intention among Chinese nurses and to explore whether career identity and work engagement mediate this association, separately and sequentially.

A cross-sectional survey was conducted among registered nurses in China. Work-family conflict, career identity, work engagement and turnover intention were assessed using validated self-report scales. Path analysis with bootstrapped confidence intervals was used to estimate the total, direct and indirect associations between work-family conflict and turnover intention.

Work-family conflict showed a substantial positive total effect on turnover intention (β = 0.394, p < 0.001). The total indirect effect of work-family conflict on turnover intention was small but significant (β = 0.053, p = 0.031). Neither work engagement alone (work-family conflict ⟶ work engagement ⟶ turnover intention) nor career identity alone (work-family conflict ⟶ career identity ⟶ turnover intention) significantly mediated this relationship. In contrast, the sequential pathway from work-family conflict to turnover intention via both career identity and work engagement (work-family conflict ⟶ career identity ⟶ work engagement ⟶ turnover intention) was statistically significant (β = 0.043, p = 0.011). After accounting for these mediators, work-family conflict remained directly associated with turnover intention (β = 0.341, p < 0.001), indicating partial mediation.

Work-family conflict was directly and indirectly associated with nurses' turnover intention. This study extends Job Demands-Resources theory (JD-R) by identifying career identity as a potential upstream professional resource and work engagement as a downstream motivational state in the association between work-family conflict and turnover intention. Given the cross-sectional design, the findings should be interpreted as evidence of theoretically grounded associations rather than causal relationships.

The findings suggest that organisational strategies aimed at reducing work-family conflict and strengthening professional resources may be relevant for supporting nurse retention. Nursing managers may consider optimising staffing and scheduling systems, developing structured career development pathways and fostering engagement-supportive leadership practices to support workforce stability.