Quiet Quitting and Associated Factors Among Healthcare Professionals: A Systematic Review and Meta-Analysis
Ehsan Zarei1, Abbas Mardani2, Moretza Arab-Zozani3
1Department of Health Policy and Management, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran, sbmu.ac.ir.
Background:
Quiet quitting (QQ), the voluntary reduction of discretionary effort while maintaining minimum job requirements, has become a pressing concern in healthcare. Understanding its prevalence and drivers is essential for sustaining workforce well-being. This systematic review and meta-analysis aimed to estimate the pooled mean of QQ among healthcare professionals (HCPs) and identify associated factors.
Methods:
This systematic review was carried out according to PRISMA guidelines by searching in three international databases including Web of Science, Scopus, and PubMed from 2020 to 2026. Quantitative data were synthesized using random-effects models. Subgroup analyses were performed based on geography, professional role, and healthcare setting. Factors associated with QQ were categorized using the expanded Job Demands-Resources (JD-R) framework.
Results:
Thirty-one studies were included in the qualitative synthesis, with 25 studies (n = 14,508 HCPs) included in the meta-analysis. The pooled mean QQ score was 2.49 (95% CI: 2.37-2.61), with significant heterogeneity (I2 = 99.2%). Subgroup analyses indicated higher QQ levels among nurses compared to other professionals and among hospital-based staff compared to those in primary care. Factors associated with QQ were clustered into four domains: (1) job demands (e.g., burnout, excessive workload, and workplace toxicity), (2) job resources (e.g., poor leadership, lack of organizational justice, and inadequate professional support), (3) personal resources (e.g., low resilience, poor coping strategies), and (4) contextual/demographic characteristics (e.g., younger age, shorter tenure). Sensitivity analyses confirmed the robustness of these findings.
Conclusion:
The findings suggest that QQ is an emerging and multifactorial phenomenon among HCPs, influenced primarily by structural and relational workplace factors. However, given the substantial heterogeneity, limited geographical representation, and variability in measurement approaches across studies, the pooled findings should be interpreted cautiously.
Implications For Nursing Management:
Healthcare organizations should prioritize "relational" resources over extrinsic rewards. Monitoring early signs of disengagement and implementing transformational leadership models can help prevent the escalation of QQ into burnout or turnover, thereby sustaining high-quality patient care.
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