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. 2026 Jul 17;13(7):e70650. doi: 10.1002/nop2.70650

The Relationship Between Achievement Goal Orientation and Nurse Turnover Intention: The Mediating Role of Organizational Commitment

Peng Zhao 1, Junxiu Li 1, Huanhuan Li 2, Shan Su 3, Xiaolan Zhou 1,✉
PMCID: PMC13376830  PMID: 42464635

ABSTRACT

Aim

This study aimed to investigate the influence of achievement goal orientation and organizational commitment on turnover intention among nurses in Shandong Province, China.

Design

A cross‐sectional questionnaire survey.

Methods

A cross‐sectional survey was conducted among 321 nurses employed in five hospitals in Shandong Province, China. Participants completed online scales measuring their achievement goal orientation, organizational commitment and turnover intention. Path analysis was used to examine the relationship between achievement goal orientation, organizational commitment and turnover intention.

Results

The findings reveal that both mastery goal orientation and performance‐approach goal orientation have a negative predictive effect on turnover intention among nurses. whereas performance‐avoidance goal orientation shows no significant effect. Furthermore, affective commitment and continuance commitment mediate the relationship between mastery goal orientation and performance‐approach goal orientation with turnover intention, respectively. However, only continuance commitment mediates the relationship between performance‐avoidance goal orientation and turnover intention.

Patient or Public Contribution

No patient or public contribution.

Keywords: achievement goal orientation, nurse, organizational commitment, turnover intention

Abbreviations

AGO

achievement goal orientation

AGO1

mastery goal orientation

AGO2

performance‐approach goal orientation

AGO3

performance‐avoidance goal orientation

OC

organizational Commitment

OC1

affective commitment

OC2

continuance commitment

TI

turnover intention

1. Introduction

Nurses constitute an indispensable component of the healthcare sector; however, The International Council of Nurses (ICN) forecasts a need for an additional 13 million nurses to alleviate the ongoing workforce shortage (Buchan et al. 2022). This global dearth of nursing professionals has profoundly affected the health and care workforce, with the situation exacerbated by increasing turnover rates among nurses, both in China and internationally (Wu et al. 2024; Ma et al. 2022). Therefore, retaining nursing staff has become a top priority for medical managers, requiring strategic interventions to address this urgent issue (Woodward and Willgerodt 2022; Cao et al. 2021). Numerous studies have examined the intention to quit from two perspectives: one focusing on organizational factors such as hospital environment and administrative support (Mathisen et al. 2021; Shimp and Jackson 2022) and the other delving into psychological effects on individuals, including job satisfaction, job stress, burnout and work‐home conflict (Daumiller and Dresel 2020; An et al. 2022; Özkan 2022; Yang and Chen 2020; Zhang et al. 2019). While these studies have provided insights into the reasons for turnover and offered practical guidelines, there has been limited attention given to the pivotal role of decision‐makers in the turnover framework. Consequently, the motivation for quitting remains insufficiently explored, and a deeper understanding of individual cognition is necessary to uncover the fundamental reasons for turnover.

While early studies by Maertz and Griffeth et al. have highlighted the influence of ‘Nine Motivational Forces’ on turnover intentions, the significance of achievement goal orientation as a motivational factor has been largely overlooked in existing research (Maertz and Boyar 2012; Maertz and Griffeth 2004). Essentially, achievement goal orientation plays a crucial role in fostering individuals' intrinsic motivation to pursue activities leading to achievement (Elliott and Dweck 1988). In recent years, there has been a growing acknowledgment of achievement goal orientation as a cognitive tendency that profoundly affects innovation capability, performance, burnout, work engagement and job‐seeking behaviour (Daumiller and Dresel 2020; Cellar et al. 2010; Marijn Poortvliet et al. 2007). Nonetheless, empirical evidence demonstrating its impact on turnover among medical staff remains limited.

Organizational commitment has emerged as a central attitudinal construct when examining factors influencing turnover intention. It captures employees' emotional attachment to organizational goals and their willingness to remain with the organization (Allen and Meyer 1996). Prior studies have consistently found a strong negative relationship between organizational commitment and both turnover intentions and actual turnover behaviour, especially in high‐stress settings such as healthcare (Tett and Meyer 2006; Ampofo and Karatepe 2021; Suárez‐Albanchez et al. 2022). Given its stability and direct relevance to retention decisions, it serves as a theoretically grounded and empirically supported mediator.

While other constructs like job engagement, emotional exhaustion and relational energy also relate to turnover, they capture more transient or interaction‐based aspects of employee experience. In contrast, organizational commitment reflects a broader and more enduring bond with the organization. Furthermore, the relationship between individual motivational traits—such as achievement goal orientation—and organizational commitment remains underexplored. This study addresses that gap by examining how nurses' achievement goals influence turnover intention via organizational commitment, thus offering new insights into the motivational foundations of nurse retention.

From the perspective of achievement goal orientation, the present study explores the role of organizational commitment in nurses' turnover intention. Specifically, it is guided by two research questions: (1) How does different achievement goal orientation vary turnover intention among individuals? (2) Does organizational commitment mediate the relationship between individual achievement goal orientation and turnover intention?

1.1. Achievement Goal Theory

Achievement Goal Theory originated from research on motivational behaviour and emerged in the 1980s. It provides a comprehensive explanation of the intrinsic motivation behind individual behaviour, making it a research hotspot in education and social psychology. It has also gradually attracted significant attention from the field of management studies (Elliot and Hulleman 2017). Achievement goal orientation is the core concept of this theory, referring to the desire states that individuals solidify in their minds during the pursuit of achievement. This state forms a stable personality trait that shapes individuals' attitudes and behaviour.

In our study, we adopt a trichotomy structure comprising learning goal orientation rooted in mastery and performance‐approach/avoidance goal orientation based on demonstration (Allen and Meyer 1996). Specifically, individuals with mastery goals believe in developing their abilities and seek to enhance their skills through challenging tasks. They enjoy taking risks, handling complex tasks and are adept at dealing with failure. Individuals with performance‐approach and performance‐avoidance goals believe that abilities are innate and fixed, using others as reference points. The difference lies in that individuals with performance‐approach goals seek approval by completing tasks within their ability range, while those with performance‐avoidance goals prefer easy tasks to avoid disapproval. In terms of personality, individuals with mastery goals typically exhibit more confidence and initiative; those with performance‐approach goals often with a competitive streak and pursue perfection and those with performance‐avoidance goals often display negative attitudes, low self‐esteem and a fear of failure (Liu et al. 2023; Ma et al. 2021).

1.2. Achievement Goal Orientation and Turnover Intention

According to the theory of person‐job fit, stability in the relationship between individuals and organizations is achieved when they share similar qualities and can effectively fulfil each other's demands (Kristof 1996).

As previously discussed, individuals with mastery goal orientation tend to utilize their strengths to continually learn and fulfil their growth requirements. They are adept at managing dynamic environments and intricate tasks. These individuals perceive organizations as launchpads for their progression rather than lifelong dwellings. In the healthcare industry, medical professionals require a strong foundation of professional knowledge and operational skills and continuous learning is essential for enhancing their expertise (Mlambo et al. 2021; Gjellebæk et al. 2020).

However, in reality, no coherent staff development plans, the absence of a career pathway, and inadequate staffing levels are the main obstacles to the continuous learning of medical professionals (Hakvoort et al. 2022). The impact of practical constraints on mastery‐oriented individuals is more pronounced compared to the two types of performance‐oriented individuals. Early studies have shown that learning and development opportunities play a crucial predictive role in the relationship between mastery‐oriented goals and turnover intentions (Lin and Chang 2005). If healthcare organizations do not offer enough learning opportunities for employees who are focused on learning, they may consider leaving to pursue their development.

Individuals with performance goal orientations may exhibit consistency in their ability perspective and reference standards. However, they differ in their behavioural motivation, task preferences and personality traits (Wang et al. 2024; Janke et al. 2016; Silver et al. 2006). Those with a performance‐approach goal orientation tend to have assertive and motivated personalities, striving for success within their capabilities to achieve satisfactory outcomes (Wang et al. 2024; Suter et al. 2022; Świątkowski and Dompnier 2020). Research indicates that medical professionals who experience high levels of job satisfaction are less likely to leave their positions (Suprapto et al. 2023; Wei et al. 2023; Gebregziabher et al. 2020). This is because they place a high value on their job performance and are committed to fulfilling their organizational responsibilities in order to enhance job security and receive positive feedback from their superiors and colleagues (Lin 2017; Joo and Ready 2012). As a result, they are focused on contributing to the success of the organization and are motivated to advance within it, rather than seeking opportunities elsewhere.

As for individuals with performance‐avoidance orientations, they often have low self‐esteem and are sensitive to negative stimuli. They are particularly attentive to information that may lead to failure and perceive challenges as threats (Marijn Poortvliet et al. 2007). Due to the increased risk and uncertainty associated with dismissal and rehiring, performance‐avoidance individuals are generally hesitant to make the decision to leave an organization.

1.3. Mediation of Organizational Commitment

Early researches have confirmed a strong causal relationship between organizational commitment and turnover (Guzeller and Celiker 2019; Dewi and Nurhayati 2021; Yasin et al. 2023; Yılmaz et al. 2023; Shaikh et al. 2022). (Meyer et al. 1993), based on a series of studies, summarized three forms of organizational commitment: affective commitment, continuance commitment and normative commitment. Normative commitment, in subsequent research, was found to have a high correlation with affective commitment (β = 0.63) (Herscovitch and Meyer 2002) and low reliability (Morrow 1993), making it unsuitable for factor analysis. Therefore, we only incorporate affective commitment and continuance commitment into the theoretical framework of this study. Affective commitment refers to the extent to which employees are involved in the organization and emotionally identify with it, serving as a crucial indicator of employee loyalty to the organization (Mercurio 2015; Guohao et al. 2021). Continuance commitment is a commitment made by employees to remain in the organization to avoid losing existing benefits. It is based on economic considerations and has a strong transactional nature (Galanaki 2019; Park et al. 2023).

Due to varying perceptions of organizational commitment stemming from different levels of self‐awareness and developmental needs, individuals with different types of achievement goal orientations are likely to exhibit divergent levels of organizational commitment (Lee et al. 2010; Zhang and Xie 2022). For individuals with mastery goal orientation, continuous learning and skill development are perpetual pursuits. When organizations provide ample opportunities for ‘continuous learning and team learning’, these individuals tend to exhibit higher levels of attachment to the organization, thereby strengthening their willingness to remain within it (Joo and Park 2010). Conversely, as previously discussed, nursing professionals have limited learning opportunities, constrained by factors such as insufficient staffing and high patient volumes within medical organizations. Therefore, when the growth of individuals with mastery goal orientation is impeded, their strong developmental needs may lead to lower levels of affective and continuance commitment to the current organization. This may subsequently result in the development of intentions to leave and the seeking of new organizations that align more closely with their new goals and values (Puhakka et al. 2021).

Secondly, individuals with a performance‐approach goal orientation are considered a pragmatic group within the organization. They excel at seizing opportunities and tend to choose tasks that showcase their abilities to gain recognition from leaders and acceptance from colleagues (Wu et al. 2023; Van Dam et al. 2020), which can be interpreted as actively seeking emotional attachment to the organization. Additional research (Mo et al. 2022; Han and Gao 2023) also suggests that these individuals have a strong sense of organizational identification, typically aligning closely with the organization's values and culture, thus forming resonance with the organization. Furthermore, individuals with a performance‐approach goal orientation are driven by the desire to pursue a clear career advancement path within the organization. The benefits associated with this, such as promotions, salary increases and harmonious relationships with colleagues, are perceived as being worth the costs associated with leaving (Abraheem et al. 2020). When all these factors are taken into consideration, it becomes evident that individuals with a performance‐approach orientation find it challenging to make the decision to leave.

Thirdly, performance‐avoidant individuals within organizations, characterized by a ‘playing it safe’ mentality, tend to favour simple tasks to evade surrounding negative evaluations (Bipp et al. 2020). Consequently, they prioritize personal gains and losses, struggling to resonate with the organization's goals and values, showing weaker emotional attachment to the organization. Pursuing personal development isn't their primary consideration; instead, they adhere to a routine completion of tasks. Additionally, Powell and Meyer (2004) found a negative correlation between employees' continuance commitment and perceived reemployment opportunities. In fact, the skills possessed by these employees do not offer a competitive edge in the labour market. A low perception of reemployment prospects enhances their continuance commitment, thereby increasing their inclination to stay.

Based on the aforementioned analysis, we posit the following hypotheses:

Mastery goal orientation positively associated with turnover intention.

Performance‐approach goal orientation negatively associated with turnover intention.

Performance‐avoidance goal orientation is negatively associated with turnover intention.

Organizational commitment, specifically affective commitment (a) and continuance commitment (b) mediate the relationship between mastery goal orientation and turnover intention.

Organizational commitment, specifically affective commitment (a) and continuance commitment (b) mediate the relationship between performance‐approach goal orientation and turnover intention.

Continuance commitment mediates the relationship between performance‐avoidance goal orientation and turnover intention.

1.4. Conceptual Framework

Figure 1 presents the conceptual framework of the study, illustrating the proposed relationships among achievement goal orientation, organizational commitment and turnover intention.

FIGURE 1.

FIGURE 1

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Theoretical framework.

2. Methods

2.1. Research Design

This quantitative relational study used an online self‐administered survey for primary data collection. This study employed a quantitative, cross‐sectional and correlational research design to examine the relationships between achievement goal orientation, organizational commitment and turnover intention among nurses. The research aimed to explore the potential mediating role of organizational commitment in the effect of achievement goal orientation on turnover intention.

2.2. Participants and Sampling

A total of 321 registered nurses were recruited from five tertiary hospitals located in Shandong Province, China, using a convenience sampling method. Participants were eligible if they (1) held a valid nursing licence, (2) had at least 1 year of clinical experience and (3) were currently working full‐time in their respective departments. Exclusion criteria included nurses in training or those on leave during the study period.

2.3. Data Collection Procedure

Data were collected over a three‐month period, from May to July 2025, via an online self‐administered questionnaire designed using ‘Wenjuanxing’ (a widely used Chinese survey platform similar to Qualtrics). The survey link was distributed through internal hospital communication channels such as email groups and WeChat workgroups. Participation was voluntary and anonymous. Prior to completing the questionnaire, all participants were informed of the purpose of the study and provided electronic informed consent. After multiple rounds of screening and verification, 22 invalid questionnaires were removed, resulting in 321 valid responses, with an effective response rate of 94%.

2.4. Ethics

The study proposal was submitted for ethical clearance to the Ethics Committee of the Third Affiliated Hospital of Shandong First Medical University (Affiliated Hospital of Shandong Academy of Medical Sciences) (Approval No: FY2025024, approval date: March 5, 2025). It was confirmed that there would be no adverse impact on the provision of medical services. Prior to the commencement of the study, informed consent was obtained from all participants. Furthermore, the data gathered from medical service providers was kept confidential.

2.5. Data Analysis

SPSS version 26 was used for descriptive and correlational analyses. Subsequently, Model 4 in PROCESS developed by Hayes (2012) was used to conduct a mediation effect test. The importance of the mediation effect was examined using 5000 samples and the bias‐corrected percentile bootstrap approach.

2.6. Measures

2.6.1. Achievement Goal Orientation

The achievement goal orientation (AGO) was measured using the Elliot and Harackiewicz (1996) trichotomy structure scale, which included mastery (AGO1), performance‐approach (AGO2) and performance‐avoidance (AGO3) goal orientations. The measure uses a 5‐point Likert scale ranging from 1 (not at all true) to 5 (very true). The scale has demonstrated good reliability in various studies, with Cronbach's α coefficients ranging from 0.76 to 0.86, indicating high internal consistency.

2.6.2. Organizational Commitment

In this study, the Organizational Commitment (OC) scale was developed by Morrow (1993), which consisted of three dimensions. As Morrow (1993) observed, the normative commitment exhibited lower reliability and overlapped with the inherent psychological and affective commitment Allen and Meyer (1996). Consequently, affective commitment (OC1) and continuance commitment (OC2) were considered. Affective commitment is defined by items pertaining to the individual's loyalty to the organization, whereas continuance commitment is characterized by items reflecting a personal or emotional attachment to the organization. The 10‐item commitment scale was measured on a 5‐point Likert scale, with 1 representing ‘not at all true’ and 5 representing ‘very true’. The scale has consistently shown robust reliability across different studies, with Cronbach's α coefficients ranging from 0.86 to 0.91, signifying a strong internal consistency.

2.6.3. Turnover Intention

In this study, employee turnover intentions are defined as an employee's behavioural intention to leave their current job either by transferring to another unit within the same organization or seeking employment at another organization. A three‐item turnover intention scale was adopted by Bentein et al. (2005). Each item was operationalized using a five‐point Likert scale, with responses ranging from 1 (not at all true) to 5 (very true). The scale has shown strong reliability across multiple studies, with a Cronbach's α coefficient of 0.83, reflecting a high level of internal consistency.

3. Results

Table 1 presents the demographic characteristics of the participants, including gender, age, years of experience in the current unit, educational level, operating unit, average monthly salary (RMB), nature of employment and title. The proportion of female participants (247, 76.9%) was higher than the proportion of female staff (74, 23.1%) in these hospitals. The results indicated that 55.4% (178) of the participants were between the ages of 20 and 30, 34.3% (110) were between 31% and 40% and 10.3% (33) were over 40 years of age. The majority of employees (37.7%, 121) had been employed in the current unit for between 3 and 8 years. A further 32.4% (104) had served in their current unit for over 8 years, 16.8% (54) for 1–3 years and the remaining participants (13.1%, 42) for less than a year. A total of 52.6% (169) of respondents had obtained a Bachelor's degree, 33.1% (106) had completed a junior college or lower level of education and 14.3% (46) had obtained a Master's degree or higher. These individuals were employed in the following departments: emergency (12.8%, 41), paediatrics (10.6%, 34), gynaecology (15%, 48), medicine (19.9%, 64), surgery (36.1%, 116) and other departments (5.6%, 18). Data also revealed the participants' monthly average salaries varied. Of the participants, 47.4% (152) earned 5000 RMB or less per month, while 40.2% (129) fell within the range of 5000 to 8000 RMB and 12.4% (40) had salaries surpassing 8000 RMB. In the group, 174 participants (54.2%) had a labour contract in the form of an employment relationship, 91 (28.3%) were employees, personnel agencies and others accounted for 56 (17.5%). 199 participants (62%) held the title of nurse practitioner, 33% (106 participants) held the title of nurse‐in‐charge, and 5% (16 participants) held the title of professor. Regarding titles, 199 participants (62%) were nurse practitioners, 106 (33%) held the title of nurse‐in‐charge, and 16 (5%) held the title of professor of nursing.

TABLE 1.

Demographic characteristics (N = 321).

Attributes Distributions Frequency Percentage
Gender Men 74 23.1
Women 247 76.9
Age 20 ~ 30 178 55.4
31 ~ 40 110 34.3
41~ 33 10.3
Years of experience in the current unit 0 ~ 1 42 13.1
1 ~ 3 54 16.8
3 ~ 8 121 37.7
8~ 104 32.4
Educational Level Junior College or lower 106 33.1
Bachelor's degree 169 52.6
Master's degree or higher 46 14.3
Working Department Emergency 41 12.8
Paediatric 34 10.6
Gynaecology 48 15
Medical 64 19.9
Surgical 116 36.1
Others 18 5.6
Average Monthly Salary (RMB) 0 ~ 5000 152 47.4
5000 ~ 8000 129 40.2
8000 ~ 15,000 35 10.9
15,000~ 5 1.6
Nature of Employment Labour contract 174 54.2
Personnel agency 26 8.1
Staff 91 28.3
Others 30 9.3
The Title Nurse Practitioner 199 62
Nurse‐in‐charge 106 33
Professor of Nursing 16 5
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Table 2 represents the factor loadings, composite reliability (CR) and average variance extracted (AVEs) values of the dimensions used in this study. Factor loadings and AVE's scores were more than 0.50, which empirically proved the convergent validity of all the constructs of the study. At the same time, most of the composite reliability was more significant than 0.8, indicating the acceptable level of CR of all the constructs of the study. The validity of the measure can be defined as the extent to which it measures what it is supposed to measure. Construct validity was checked by using convergent validity and discriminant validity. Convergent validity was checked through factor loadings, CR and AVEs. However, discriminant validity was analysed by comparing the square root of AVEs with relevant correlations where the square root of AVEs should be higher than the pertinent relationships. Overall, these results proved the validity and reliability of all the constructs used in this study.

TABLE 2.

Reliability and convergence validity of variables.

Variables Items Cronbach's α Factor loading Composite reliability Average variance extracted (AVE)
Mastery goal orientation 5 0.86 0.69 ~ 0.79 0.86 0.56
Performance‐approach goal orientation 5 0.82 0.55 ~ 0.83 0.84 0.52
Performance‐avoidance goal orientation 3 0.76 0.77 ~ 0.85 0.85 0.66
Affective commitment 3 0.91 0.80 ~ 0.87 0.87 0.67
Continuance commitment 6 0.86 0.61 ~ 0.85 0.86 0.56
Turnover Intention 3 0.83 0.88 ~ 0.97 0.94 0.84
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Table 3 presents the values of means, standard deviations and correlations between the research variables. All the skewness and kurtosis values lay within the range indicated normality of the data. The mean value of AGO1, AGO2, AGO3, OC1, OC2 and TI were 3.94, 3.83, 2.47, 3.21, 3.72 and 1.83, respectively. As the table showed, AGO1 was correlated with AGO2(r = 0.45, p < 0.01), OC1(r = 0.24, p < 0.01) and OC2(r = 0.40, p < 0.01), TI(r = −0.18, p < 0.01), respectively; AGO2 was correlated with AGO1(r = 0.45, p < 0.01), AGO3(r = −0.13, p < 0.05), OC1(r = 0.18, p < 0.01), OC2(r = 0.66, p < 0.01) and TI(r = −0.21, p < 0.01); AGO3 was correlated with AGO2(r = −0.13, p < 0.01), OC1(r = 0.25, p < 0.01); OC1 was correlated with AGO1(r = 0.24, p < 0.01), AGO2(r = 0.18, p < 0.01), AGO3(r = 0.25, p < 0.01), OC2(r = 0.41, p < 0.01) and TI(r = −0.31, p < 0.01); OC2 was correlated with AGO1(r = 0.40, p < 0.01), AGO2(r = 0.66, p < 0.01), OC1(0.41,p < 0.01) and TI(r = −0.36, p < 0.01); TI was correlated with AGO1(r = −0.18, p < 0.01), AGO2(r = −0.21, p < 0.01), OC1(r = −0.31, p < 0.01), OC2(−0.36, p < 0.01). Correlation coefficients indicated the assumptions of the study were met.

TABLE 3.

Correlation analysis (N = 321).

Variable Mean SD 1 2 3 4 5 6
1.AGO1 3.94 0.61 0.75
2.AGO2 3.83 0.62 0.45** 0.72
3.AGO3 2.47 0.80 0.02 −0.13* 0.81
4.OC1 3.21 0.83 0.24** 0.18** 0.25** 0.83
5.OC2 3.73 0.79 0.40** 0.66** −0.06 0.41** 0.74
6.TI 1.83 1.27 −0.18** −0.21** 0.00 −0.31** −0.36** 0.89
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Note: The diagonal bold is the root mean square of AVE; p‐value *p < 0.05; **p < 0.01*** < 0.001.

Abbreviation: AGO1, mastery goal orientation, AGO2, performance‐approach goal orientation, AGO3, performance‐avoidance goal orientation, OC1, affective commitment, OC2, continuance commitment, TI, turnover intention.

The values on the diagonal show the square roots of the average variance extracted (AVE). Each latent construct has a higher value of its square root of average variance (AVEs) compared with the respective correlation of the latent construct. So, these results from measurement model analysis confirmed the convergent and discriminant validity of all the measures used in this study.

Table 4 Hierarchical regression controlling for working years revealed that both AGO1 (B = −0.346, p < 0.01) and AGO2 (B = −0.401, p < 0.001) significantly and negatively predicted turnover intention. Therefore, H2 was supported, whereas H1 was not supported because the observed relationship was opposite to the hypothesized direction. However, AGO3 had no significant direct predictive effect on TI (B = 0.010, p = 0.907), so H3 was not supported.

TABLE 4.

Regression and mediation test (N = 321).

Regression
Variables Unstandardized Coefficients Standardized Coefficients p Collinearity
B Std. Error Beta t Tol VIF
1 (Constant) 2.447 0.257 9.508 ***
Years −0.242 0.097 −0.139 −2.51 * 1 1
2 (Constant) 4.349 0.594 7.327 ***
Years −0.179 0.096 −0.103 −1.855 0.065 0.967 1.034
AGO1 −0.346 0.116 −0.165 −2.977 ** 0.973 1.028
AGO2 −0.401 0.113 −0.195 −3.541 *** 0.983 1.017
AGO3 0.01 0.088 0.007 0.117 0.907 0.999 1.001
1 △R 2 0.019
2 △R 2 0.045
Mediation Test
Path Effect type Coefficient SE t p BootLLCI BootULCI Sig Mediation type
AGO1 → TI Total −0.3843 0.1151 −3.3386 0.0009 −0.6108 −0.1578 Yes
Direct −0.0577 0.1179 −0.4892 0.625 −0.2897 0.1743 No
Indirect (OC1) −0.0935 0.0402 −0.1810 −0.0268 Yes Significant
Indirect (OC2) −0.2332 0.0675 −0.3733 −0.1096 Yes Significant
Total Indirect −0.3266 0.0779 −0.4895 −0.1819 Yes Full Mediation
AGO2 → TI Total −0.4314 0.1128 −3.8245 0.0002 −0.6533 −0.2095 Yes
Direct 0.042 0.1415 0.2968 0.7668 −0.2364 0.3203 No
Indirect (OC1) −0.0668 0.0348 −0.1453 −0.0113 Yes Significant
Indirect (OC2) −0.4066 0.1115 −0.6345 −0.1949 Yes Significant
Total Indirect −0.4734 0.1138 −0.7060 −0.2505 Yes Full Mediation
AGO3 → TI Total 0.0022 0.0889 0.0243 0.9807 −0.1727 0.177 No
Direct 0.0536 0.0857 0.6247 0.5326 −0.1151 0.2223 No
Indirect (OC1) 0.0276 0.0298 −0.0299 0.0908 No Not significant
Indirect (OC2) −0.0790 0.0341 −0.1571 −0.0232 Yes Significant
Total Indirect −0.0514 0.0526 −0.1565 0.0501 No No significant total mediation
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Note: p‐value * < 0.05, ** < 0.01, *** < 0.001. Bold values indicate statistically significant effects.

Abbreviation: AGO1, mastery goal orientation, AGO2, performance‐approach goal orientation, AGO3, performance‐avoidance goal orientation, OC1, affective commitment, OC2, continuance commitment, TI, turnover intention.

Mediation analyses via Hayes' PROCESS Model 4 with 5000 bootstrap samples were further conducted. For AGO1, OC1 and OC2 both exerted significant indirect effects on the AGO1–TI link and the insignificant direct effect verified full mediation, supporting H4a and H4b. Similarly, OC1 and OC2 significantly mediated the AGO2–TI association with a non‐significant direct effect, confirming full mediation and supporting H5a and H5b.

Regarding H6, which proposed that continuance commitment (OC2) mediates the relationship between performance‐avoidance goal orientation (AGO3) and turnover intention (TI), the indirect effect through OC2 was statistically significant (Effect = −0.0790, 95% CI [−0.1571, −0.0232]). In contrast, the indirect effect through OC1 was non‐significant (Effect = 0.0276, 95% CI [−0.0299, 0.0908]). Therefore, H6 was supported, indicating that continuance commitment serves as a mediator in the relationship between performance‐avoidance goal orientation and turnover intention.

4. Discussion

4.1. Direct Effect of Achievement Goal Orientation on Turnover Intention

Contrary to H1, mastery goal orientation was negatively associated with turnover intention. This finding suggests that nurses with stronger mastery goals may perceive tertiary hospitals as environments that support professional growth and career development, thereby reducing their intention to leave. Through further interviews and investigations, it has been elucidated that this result can be examined more thoroughly by employing the concept of the ‘siphon effect’ in public first‐class tertiary hospitals. These medical institutions in China aggregate the highest‐quality hardware equipment, medical staff and business expansion channels available locally. Such superior resources serve as fundamental guarantees for medical personnel to actualize their intrinsic value and sustain professional development, surpassing the capabilities of ordinary and private hospitals. Hence, these factors are likely to attenuate employees' inclination towards turnover (Lu et al. 2023). Hospitals with relatively constrained medical resources may offer better validation for this hypothesis. Consequently, the research team's focus is expected to transition towards ordinary hospitals in subsequent investigations. This finding may provide useful implications for healthcare managers. Individuals with mastery goal orientation exhibit positive affect and exceptional capabilities, serving as exemplary role models for departments and organizations. Their enthusiasm for work and contribution to organizational performance far exceeds those of other types of medical staff.

The performance‐approach goal orientation is negatively predictive of turnover intention, which is consistent with the hypothesis. In contrast to the negative traits associated with performance‐avoidance goal orientation, individuals with a performance‐approach goal orientation strive to attain the best performance rewards and positive evaluations. In other words, individuals with such a goal orientation are more likely to be classified as perfectionists, as they are more concerned with external positive evaluations. Research (Knockaert et al. 2024; Tojib et al. 2022) indicates that individuals with such personalities exert a positive influence on their own performance. In their pursuit of surpassing others, they may even adopt various positive strategies to achieve their goals (Lee et al. 2022; Terho et al. 2015). In light of these characteristics, managers can stimulate their profit‐oriented nature and encourage them to contribute greater performance to the organization.

The predictive effect of performance‐avoidance goal orientation on turnover intention did not reach significance. Further interviews revealed that individuals with this orientation tend to have low self‐esteem and are sensitive to negative evaluations. When completing turnover questionnaires, they may harbour concerns about the potential repercussions of disclosing their responses, which may lead to adverse impacts on themselves. Individuals with this mindset may be inclined to conceal their genuine motives when completing questionnaires, thereby failing to reach the expected level of significance in relevant indicators. Furthermore, factors such as the public health crisis and other boundary conditions may also contribute to disturbances in the results.

4.2. Mediational Examination of Organizational Commitment

As anticipated, affective commitment and continuance commitment both mediate the effects of mastery goals and performance‐approach goals on turnover intentions. According to our findings, affective commitment accounts for two‐thirds of the total indirect effect, indicating that both groups exhibit higher loyalty to their respective medical organizations. Specifically, under the predominant influence of social exchange attributes, Chinese employees' affective commitment is more influenced by factors such as ‘job stability’ and prospects for promotion (Liu et al. 2020), while first‐class tertiary hospitals, endowed with superior resources, can provide stable job positions and favourable avenues for promotion, thereby fully explaining why these two groups exhibit heightened levels of affective commitment. For managers, both types of employees represent ideal staff. Therefore, they need to carefully consider how to effectively create a high‐commitment organizational climate, which will enhance performance outcomes among individuals with different achievement goal orientations.

In the mediating effect of organizational commitment on the relationship between performance‐avoidance goal orientation and turnover intention, only continuance commitment exhibited a mediating effect, a finding consistent with H6. Employee's continuance commitment is relatively intuitive and significantly correlated with working hours (Rumangkit and Zuriana 2019; Wang et al. 2020). As individuals accrue tenure within the organization, the accumulated benefits make it difficult for such groups to detach; however, the controversy remains regarding whether this ‘forced’ retention behaviour is advantageous to the organization. Research indicates (Ahmad et al. 2020), although individuals may not leave their positions for various reasons, they may engage in passive behaviours such as decreased performance. These findings may offer preliminary guidance for nursing management and retention strategies. However, because the present study employed a cross‐sectional design, causal inferences should be made with caution.

4.3. Implications

The present findings may provide preliminary insights for nursing management and workforce retention. Rather than using achievement goal orientation as a basis for departmental assignment decisions, nurse managers may consider goal orientation as one of several psychological factors when designing professional development programs, mentoring strategies, career planning initiatives and retention interventions.

For nurses with stronger mastery goal orientation, hospitals may provide opportunities for continuous learning, professional development and skill enhancement. For those with stronger performance‐approach goal orientation, appropriate recognition and performance feedback may help strengthen organizational attachment. In addition, fostering organizational commitment may be an effective strategy for reducing turnover intention across different goal‐orientation profiles.

These practical implications should be interpreted cautiously because the present study employed a cross‐sectional design and cannot establish causal relationships.

4.4. Limitations

This study, set against the backdrop of the global pandemic outbreak, explores the turnover intentions of healthcare personnel with different achievement goal orientations, as well as the crucial role of organizational commitment therein. The research findings hold strong practical significance, yet they also entail certain limitations:

Firstly, the sample data collected for this study is based on a cross‐sectional design. Whether individual turnover intentions influenced by achievement goal orientations would undergo alterations due to temporal interference necessitates further longitudinal tracking to validate the hypothesis. Secondly, despite achievement goal orientations existing as stable personality traits within individual cognition, they can also undergo changes under specific situational influences (Senko and Harackiewicz 2002). In subsequent research, it is imperative to examine the impact of more boundary conditions and explore the excavation of moderating variables such as leadership styles, organizational climates and career development. Lastly, this study solely selected public three‐shift hospitals as its research subjects. However, empirical investigations reveal a more severe talent drain in other kinds of public hospitals and private hospitals. To address the rebalancing of medical resources, future steps will involve enriching and optimizing theoretical models, expanding the research sample to include other kinds of public hospitals, private hospitals and even grassroots medical institutions and delving into the reasons for medical staff turnover at various levels and regions while seeking solutions to fundamentally resolve the issues stemming from medical personnel shortages and turnover.

5. Conclusions

Firstly, the associations between three types of achievement goal orientations and turnover intentions vary. Both mastery goal orientation and performance‐approach goal orientation negatively predict turnover intentions, yet there is no evidence to suggest a connection between performance‐avoidance goal orientation and turnover intentions. Secondly, within the mediation of organizational commitment, both affective commitment and continuance commitment fully mediate the effects of mastery goal orientation and performance‐approach goal orientation on turnover intentions, with a stronger mediating effect observed for affective commitment. What's more, among nurses with a performance‐avoidance goal orientation, only continuance commitment mediated the relationship between performance‐avoidance goal orientation and turnover intention.

Author Contributions

Peng Zhao: conceptualization, methodology, data collection, writing – original draft, review and editing. Junxiu Li: writing – review and editing. Huanhuan Li: data collection, interview. Shan Su: data collection, questionnaire revision. Xiaolan Zhou: conceptualization, supervision, project administration.

Funding

The authors have nothing to report.

Disclosure

Artificial intelligence (AI) tools were not used for manuscript drafting, language editing, or data analysis throughout the research and writing process.

Ethics Statement

The study proposal was submitted for ethical clearance to the Ethics Committee of the Third Affiliated Hospital of Shandong First Medical University (Affiliated Hospital of Shandong Academy of Medical Sciences) (FY2025024). It was confirmed that there would be no adverse impact on the provision of medical services. Prior to the commencement of the study, informed consent was obtained from all participants. Furthermore, the data gathered from medical service providers was kept confidential.

Consent

The authors have nothing to report.

Conflicts of Interest

The authors declare no conflicts of interest.

Acknowledgements

The authors would like to express sincere gratitude to all the nurses who voluntarily participated in this study and provided their invaluable support throughout the investigation.

Data Availability Statement

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

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Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Data Availability Statement

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

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