Factors Affecting Burnout and Turnover Intention among Nurses: An Integrative Literature Review
Keywords:
Nurses, Burnout, Turnover Intention, Integrative Literature ReviewAbstract
Burnout and nurse turnover remain major challenges in the Thai healthcare system, as they directly affect workforce capacity, work performance, quality of care, and continuity of patient care. This integrative literature review aimed to collect, analyze, and synthesize empirical evidence on work-related burnout and turnover intention among nurses, using the Whittemore and Knafl framework, which comprises four stages: problem identification, literature search, quality appraisal, and data analysis. The literature search was conducted in ThaiJO, PubMed, ProQuest, ScienceDirect, and Scopus for studies published between 2020 and 2025, with the Population–Exposure–Outcome (PEO) framework used to guide keyword selection.
The search identified ten eligible studies, consisting of three descriptive studies and seven systematic reviews and meta-analyses. Following quality appraisal using the Joanna Briggs Institute (JBI) tools, the descriptive cross-sectional studies were classified as Level 4.b (n = 3) and Level 4.a (n = 1), while the systematic reviews were classified as Level 1.b (n = 1), Level 3.b (n = 4), and Level 3.a (n = 1).
The synthesis indicated that nurse burnout and turnover intention are not attributable to a single factor, but rather are associated with multiple interrelated dimensions. These factors can be categorized into three main domains: 1. individual and personnel support factors, 2. work environment and workload-related factors, and 3. organizational policy and management factors.This review highlights the need for integrated policy and management approaches to support nurse retention and strengthen workforce sustainability, thereby promoting the long-term well-being of the Thai healthcare system.
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