Factors Associated With Turnover Intention Among Nurses: A Quantile Regression Analysis

Objectives: To investigate the factors influencing turnover intention among nurses, and to examine the association between psychological distress and turnover intention across different types of workplace bullying exposure. Methods: A cross-sectional study was conducted with 188 registered nurses in Hong Kong, recruited through convenience sampling. Data collection took place from April 2020 to September 2021. Quantile regression analysis, which captures relationships that may be overlooked by ordinary least squares regression, was employed to explore the factors influencing turnover intention varied across different levels. This analysis examined the associations between demographic and work-related characteristics, work events, work environment features, affective states and turnover intention across quantiles ranging from 0.05 to 0.95. Results: Quantile regression analysis revealed that only indirect or direct exposure to workplace bullying was positively associated with turnover intention at the 25th percentile, while both forms of exposure were significantly associated with turnover intention across all percentiles. The absence of workplace violence reporting procedures was positively associated with turnover intention at the highest quantile. Depressive symptoms were significantly associated with turnover intention at the 5th, 25th and 50th percentiles. Additionally, nurses exposed to both direct and indirect workplace bullying exhibited higher levels of psychological distress and turnover intention compared to those exposed to either form alone or those without exposure. Conclusions: Exposure to workplace bullying, the absence of workplace violence reporting procedures, and depressive symptoms significantly contribute to turnover intention among nurses across different levels. To improve nurse retention and workforce sustainability, healthcare organisations should implement targeted interventions that address turnover risk at varying levels. Relevance to Clinical Practice: These findings underscore the need for healthcare organisations to develop and enforce strategies aimed at preventing workplace bullying, providing comprehensive mental health support and establishing effective reporting mechanisms for workplace violence. Patient and Public Contribution: No patient or public involvement.