Job satisfaction, resilience and social support in relation to nurses' turnover intention based on the theory of planned behaviour: A structural equation modelling approach

Background Many national studies have shown that nurses have a high turnover rate. The key to maintaining the stability of nursing staff is to explore the factors that affect their turnover intention; however, no research has been performed to explore the influencing factors and mechanisms of nurses' turnover intention based on the Theory of Planned Behaviour. Aim Based on the Theory of Planned Behaviour, examining the relationships among resilience, job satisfaction, social support and turnover intention of nurses, a structural equation model was constructed to examine the mediating role of job satisfaction and social support between resilience and turnover intention. Methods In this descriptive cross-sectional study, a total of 350 questionnaires were distributed to participants from three tertiary hospitals in Changchun, Jilin Province, between December 2018 and March 2019. Results The final model fits well. Job satisfaction and social support directly influences turnover intention. Resilience indirectly influences turnover intention through job satisfaction and social support. Conclusion Turnover intention is a complex variable, which is directly and indirectly affected by many factors. In this study, a new structural equation model was proposed, which laid a foundation for future longitudinal studies. Summary statement What is already known about this topic? Globally, the high rate of nurse turnover is one of the major reasons for the shortage of nurses. The turnover intention of nurses is influenced by many factors. Few studies have examined the influencing factors of turnover intention based on theory or constructed a structural equation model to clarify the mechanism. What does this paper contribute? The Theory of Planned Behaviour presents the key determinants of behaviour and can guide our understanding of the behavioural mechanism of the turnover intention of nurses. Three influencing factors of turnover intention based on the Theory of Planned Behaviour (resilience, job satisfaction and social support), directly or indirectly affected turnover intention. The implications of this paper: Future interventions should consider the indirect role of resilience. A positive effect of increased social support and job satisfaction on turnover intention occurs through improved resilience. Longitudinal studies with larger samples are needed in the future to verify the effectiveness of the mediating effect.