Nurses' Fatigue, Job Stress, Organizational Culture, and Turnover Intention: A Culture-Work-Health Model

We examined the factors affecting clinical nurses' turnover intention and constructed a structural equation model based on the Culture-Work-Health Model. This cross-sectional study utilized self-administered questionnaires. Registered nurses (N = 252) from four tertiary hospitals participated. Factors affecting nurses' turnover intention included the organizational culture, job stress, and fatigue (explanatory power = 56.7%), and the model showed acceptable goodness of fit. In the final turnover intention model, fatigue and job stress had direct effects and the organizational culture had indirect effects. The organizational culture also had indirect effects on turnover intention through job stress and fatigue. This model, therefore, effectively explained how nursing organizational culture, job stress, and fatigue affect their turnover intention. The results provide support for theory-driven interventions to address developing intention to stay at work among experienced nurses.