Perceived stress, sickness presenteeism, job burnout, and turnover intention among nurses: A cross-sectional survey

Na Wei; Yuqing Wang; Guanglin Liu; Youjuan Zhang; Li Li; Xiaoyan Lv; Patricia M Davidson; Yingjuan Cao

doi:10.1016/j.outlook.2025.102650

Perceived stress, sickness presenteeism, job burnout, and turnover intention among nurses: A cross-sectional survey

Nurs Outlook. 2026 Jan 23;74(2):102650. doi: 10.1016/j.outlook.2025.102650. Online ahead of print.

Authors

Na Wei¹, Yuqing Wang¹, Guanglin Liu¹, Youjuan Zhang², Li Li³, Xiaoyan Lv³, Patricia M Davidson⁴, Yingjuan Cao⁵

Affiliations

¹ School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China.
² Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China.
³ Department of Nursing, Qilu Hospital of Shandong University, Jinan, Shandong, China.
⁴ The Vice-Chancellor's Unit, University of Wollongong, Wollongong, NSW, Australia.
⁵ School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China; Department of Nursing, Qilu Hospital of Shandong University, Jinan, Shandong, China. Electronic address: caoyj@sdu.edu.cn.

PMID: 41579436
DOI: 10.1016/j.outlook.2025.102650

Abstract

Background: The global nursing shortage is a pervasive and urgent issue. Nurse turnover exacerbates this problem, leading to increased operational costs and a decline in the quality of care.

Purpose: To examine the mediating effects of sickness presenteeism and job burnout on the relationship between perceived stress and turnover intention among nurses.

Methods: The bootstrap method was applied to cross-sectional data from the Chinese Nurses' Health Cohort Study (TARGET), which included 41,270 nurses.

Discussion: The serial multiple mediation model of sickness presenteeism and job burnout in the relationship between perceived stress and turnover intention was found to be statistically significant.

Conclusion: The findings will inform strategies for hospital policymakers and managers to avoid brain drain by alleviating sickness presenteeism and job burnout among nurses.

Keywords: Job burnout; Perceived stress; Serial-multiple mediation; Sickness presenteeism; Turnover intention.