Emotional labour and turnover intention among nurses in China: Mediating effects of nurse-patient relationship and self-rated health

Zhixin Liu; Huanyu Zhang; Junping Liu; Juan Zhao; Yajie Feng; Jie Liu; Siyi Tao; Wei Liu; Dandan Zou; Chen Wang; Nan Wang; Zhaoyue Liu; Xinru Liu; Lin Wu; Libo Liang; Weilan Xu; Qunhong Wu; Chaojie Liu

doi:10.1111/inr.12933

Emotional labour and turnover intention among nurses in China: Mediating effects of nurse-patient relationship and self-rated health

Int Nurs Rev. 2024 Jan 8. doi: 10.1111/inr.12933. Online ahead of print.

Authors

Zhixin Liu^{1

2}, Huanyu Zhang¹, Junping Liu¹, Juan Zhao³, Yajie Feng¹, Jie Liu⁴, Siyi Tao⁵, Wei Liu¹, Dandan Zou⁶, Chen Wang⁷, Nan Wang¹, Zhaoyue Liu¹, Xinru Liu¹, Lin Wu¹, Libo Liang¹, Weilan Xu⁸, Qunhong Wu¹, Chaojie Liu⁹

Affiliations

¹ Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, China.
² Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China.
³ Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
⁴ The 2nd Affiliated Hospital of Harbin Medical University, Harbin, China.
⁵ Clinical College, Anhui Medical University, Hefei, China.
⁶ Jin Shan Hospital of Fudan University, Shanghai, China.
⁷ Chongqing Health Center for Women and Children, Chongqing, China.
⁸ College of Nursing, Qiqihar Medical University, Qiqihar, China.
⁹ Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia.

PMID: 38191960
DOI: 10.1111/inr.12933

Abstract

Aim: This study tested the mediating role of the nurse-patient relationship and self-rated health in the effect of emotional labour on turnover intention among nurses in China.

Background: The underlying mechanism behind the effect of emotional labour on turnover intention remains inadequately understood.

Introduction: Nurses with a high level of emotional labour are predisposed to experiencing poor health and tension in their relationships with patients, which may increase turnover intention.

Methods: A cross-sectional survey of 527 nurses in a public tertiary hospital in Qiqihar, located in China's Heilongjiang province, was conducted. Emotional labour and turnover intention were assessed using existing validated scales containing multiple items, while the nurse-patient relationship and self-rated health were assessed using single items, respectively. Baron and Kenny's causal steps and the Karlson/Holm/Breen method were adopted to test the mediating effects of the nurse-patient relationship and self-rated health in the association between emotional labour and turnover intention after adjusting for variations in sociodemographic and job characteristics.

Results: Emotional labour was positively associated with turnover intention. Self-rated poor health and a disharmonious nurse-patient relationship partially mediated the positive effect of emotional labour on turnover intention.

Conclusions: Emotional labour significantly affects the turnover intention of nurses working in public tertiary hospitals in China, and this effect is partially mediated by self-rated health and the nurse-patient relationship.

Implications for nursing practice and nursing policy: Giving more attention to nurses' negative emotions and work attitudes is crucial. Developing comprehensive strategies for enhancing nurses' emotional management ability, promoting their physical and psychological well-being, and improving nurse-patient relationship to reduce nurses' turnover.

Keywords: China; emotional labour; nurse; nurse-patient relationship; self-rated health; turnover intention.