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. 2026 Aug 23;73(3):e70214. doi: 10.1111/inr.70214

Psychological Capital and Job Performance Mediate Psychological Contract and Turnover Intention in Young Nurses

Zhengyi Ma 1, Hangna Qiu 1, Dongrun Liu 1, Juntong Jing 1, Yongkang Fu 1, Guangli Lu 2, Chaoran Chen 1,✉
PMCID: PMC13501065  PMID: 42634405

ABSTRACT

Aim

To explore the effect of psychological contract on turnover intention among young nurses and to investigate the mediating roles of psychological capital and job performance.

Background

The high turnover rate of young nurses poses a significant risk to the stability of the nursing workforce and organizational effectiveness. Although psychological contract has been recognized as an important factor influencing employee retention, how it affects turnover intention in young nurses remains underexplored.

Methods

A cross‐sectional survey was conducted among young nurses working in hospitals. Standardized questionnaires were used to assess psychological contract, psychological capital, job performance, and turnover intention. A mediation model was established to examine the direct and indirect relationships among the variables.

Results

A higher perceived level of psychological contract fulfillment was associated with lower turnover intention among young nurses. Higher levels of psychological capital and better job performance were also associated with lower turnover intention. Psychological capital and job performance partially mediated the relationship between psychological contract and turnover intention.

Discussion

The findings highlight the importance of psychological and performance factors in understanding turnover intention. Psychological contract fulfillment was positively associated with enhanced intrinsic motivation and professional identity, which in turn corresponded to improved job performance and reduced turnover intention.

Conclusion

Psychological contract is a key correlate of turnover intention in young nurses, and it is associated with turnover intention through the mediating roles of psychological capital and job performance.

Implications for Nursing

Interventions that strengthen psychological support, enhance confidence and resilience, and promote performance development may be associated with reduced turnover intention among young nurses.

Implications for Nursing Policy

Healthcare institutions should prioritize policy initiatives that meet the psychological expectations of young nurses, support their career development, and reinforce a retention‐oriented management system to stabilize the nursing workforce.

Keywords: job performance, psychological capital, psychological contract, turnover intention

1. Introduction

As a critical component of the healthcare workforce, nurses play an essential role in safeguarding public health. Their responsibilities include accurately following medical orders to perform various clinical activities, conducting nursing assessments, ensuring patient safety, and preventing and controlling infections. With the increasing aging of the population, the demand for nursing services, especially geriatric care, is growing (Commission 2022). However, the nurse turnover rate has remained persistently high, and workforce shortages have become a global challenge. The World Health Organization previously estimated a potential shortfall of approximately 18 million nurses and midwives globally by 2030 (WHO 2010). In China, nurses also constitute a professional group with a relatively high turnover rate. Data indicate that the turnover rate of nurses in Chinese tertiary hospitals peaks at 46.26% (Li 2024), with turnover intention being particularly prominent among young nurses under the age of 35 (Ling et al. 2024). High nurse turnover not only increases the workload and stress of incumbent nurses but also strengthens their own turnover intention (Dai 2023), thereby exacerbating the ongoing loss of nursing personnel. Turnover intention refers to an employee's conscious and deliberate desire to leave an organization after working there for a certain period and is a direct predictor of actual turnover (Mobley 1977). Young nurses generally refer to nursing staff aged 20–35 years. As emerging and core forces of the nursing workforce, the loss of these talents forces hospitals to invest additional human and financial resources in recruitment and training, which not only undermines the stability of the nursing team but also affects overall nursing quality (Mcdermid 2020). Given this, it is necessary to thoroughly investigate the influencing factors of turnover intention among young nurses, as this has significant practical implications for reducing nursing workforce attrition, improving the quality of nursing care, and addressing challenges such as population aging.

1.1. Background

Employees’ turnover intention is influenced by many factors, among which the level of psychological contract fulfillment shows a significant negative correlation with turnover intention (Alev et al. 2021; He et al. 2023). Psychological contract, a concept introduced by Professor Argyris, refers to employees’ beliefs regarding the mutual obligations and expectations between themselves and their organization, based on perceived promises and the employment relationship (Rousseau 1989). It is important to emphasize that, in this study, psychological contract refers to nurses’ subjective perceptions of contract fulfillment rather than objectively verified organizational practices. When the psychological contract is fulfilled, employees tend to maintain positive work attitudes and emotions; conversely, when it is breached, employees are more likely to experience negative emotions and exhibit adverse work behaviors, which is associated with detrimental effects on organizational interests (Topa et al. 2022). Similarly, He et al. (2023) found that psychological contract was significantly negatively associated with turnover intention among knowledge workers. In addition, a study by Weidi (2020) focusing on teachers revealed that psychological contract breach or violation was positively associated not only with teachers’ negative emotions but also with poor team climate and low cohesion; these factors, in turn, were significantly and positively correlated with teachers’ turnover intention. Given that previous studies have mostly targeted corporate employees (Hui 2021), university teachers (Alev et al. 2021), and other populations, relatively few studies have focused on nurses, and essentially none have focused specifically on young nurses. Therefore, this study aims to explore the relationship between psychological contract and turnover intention among young nurses. Based on this, Hypothesis 1 is proposed: Psychological contract is significantly negatively associated with turnover intention in young nurses.

Psychological capital refers to an individual's positive psychological state during development, encompassing four core dimensions: self‐efficacy, optimism, hope, and resilience (Luthans et al. 2007). As its theoretical framework has evolved, the practical value of psychological capital has been widely validated across multiple fields. For example, Chen et al. (2023) demonstrated that psychological contract is indirectly associated with employee work engagement through the mediating variable of psychological capital. Liu (2024) found that, among Chinese employees, the fulfillment of psychological contracts by enterprises was positively associated with employees’ levels of psychological capital. In the nursing field, research consistently shows a significant negative relationship between nurses’ psychological capital and turnover intention (Dwyer et al. 2019; Zheng et al. 2025). Nurses with higher levels of psychological capital tend to maintain positive attitudes when facing work stress, which is associated with lower turnover intention (Zheng et al. 2025). Furthermore, a large‐scale survey of 1152 healthcare workers in Anhui Province confirmed that higher levels of psychological capital were negatively associated with turnover intention (Chen et al. 2021). Based on this, Hypothesis 2 is proposed: Psychological capital mediates the relationship between psychological contract and turnover intention in young nurses.

Job performance refers to the work outcomes achieved by employees or teams through their efforts within a specific period and serves as an important basis for evaluating work efficiency and value (Bernardin et al. 1997). For nurses, job performance reflects the effectiveness of their professional knowledge and skills in nursing practice and indicates their actual work ability and professional attitudes in clinical settings (Jiang et al. 2024). Studies have shown that psychological contract is significantly positively associated with job performance(Danial and Nasir 2020). In addition, job performance is also associated with turnover intention; existing research indicates a negative relationship between employee job performance and turnover intention (Widyanty and Prasetya 2023). Meanwhile, psychological capital is significantly positively associated with job performance and is an important factor related to job performance (Huang et al. 2020). A study focusing on Chinese healthcare workers further confirmed that higher levels of psychological capital were positively associated with improved job performance (Xu et al. 2024). Building on the above discussion of relationships among the variables, this study proposes Hypothesis 3: Job performance mediates the relationship between psychological contract and turnover intention in young nurses; and Hypothesis 4: Psychological contract is negatively associated with turnover intention in young nurses through the chain mediating effects of psychological capital and job performance.

In summary, although previous studies have examined the relationship between psychological contract and turnover intention, research on the intrinsic association between the two remains insufficient. This study takes young nurses as the research subjects, exploring the relationship between psychological contract and turnover intention, as well as the roles of psychological capital and job performance in this relationship. The aim is to more deeply reveal the intrinsic association between psychological contract and turnover intention among young nurses and to provide empirical evidence for interventions aimed at reducing turnover intention in this population.

2. Methods

2.1. Participants

A cross‐sectional survey was conducted among young nurses from three hospitals in Henan Province, China, using a convenience sampling method between October and December 2024. Before the survey, we obtained permission from the hospital administrators after full communication to distribute the questionnaires to the nursing staff. Inclusion criteria were: (1) being a registered nurse; (2) aged ≤35 years; and (3) providing informed consent and voluntarily participating in the study. The exclusion criterion was incomplete completion of the questionnaire.

The sample size was calculated using the formula n = Z 2 p(1−p)/d 2 (Sun 2013), where n is the sample size, Z is the Z‐statistic for the confidence level, d is the half‐width of the confidence interval (i.e., the survey margin of error), and p is the population proportion. In practice, p was set at 0.5 to maximize n. Considering sampling costs and time, we selected a 5% precision level at a 95% confidence level. Under different absolute error levels, the maximum required sample size for a 95% confidence level was 385. Based on empirical considerations, the design effect k was set at 1.2, and a nonresponse rate of 20% was assumed, yielding a required sample size of 385 × 1.2 / (1 – 0.2) = 578. To account for sampling errors and invalid questionnaires, a total of 830 questionnaires were distributed. After excluding invalid and incomplete responses, 789 valid questionnaires were retrieved, representing an effective response rate of 95.06%.

2.2. Measurement Instruments

The measurement instruments used in this study included the Turnover Intention Questionnaire, the Psychological Contract Scale, the Psychological Capital Scale, and the Job Performance Scale. For each instrument, the development and adaptation background, dimensional structure, scoring method, score interpretation, and reliability results are described below.

2.2.1. Turnover Intention Questionnaire

The Turnover Intention Questionnaire, originally developed by Michaels and Spector (1982) and translated and revised by Taiwanese scholars Li et al. (2003), comprises six items across three dimensions (Paliga et al. 2022). The scale uses a Likert‐4 point scoring method, with scores ranging from 1 to 4 corresponding to “very low” to “very high.” Higher scores indicate stronger turnover intention (Li et al. 2003). The Cronbach's α coefficient of this scale was 0.77, indicating acceptable reliability (Li et al. 2003). In this study, the Cronbach's α coefficient was 0.74.

2.2.2. Psychological Contract Scale

The Psychological Contract Scale, developed by Liu et al. (2008), consists of eight items across two dimensions: performance‐based and loyalty‐based. The scale uses a Likert‐5 point scoring method, with scores ranging from 1 to 5 corresponding to “strongly disagree” to “strongly agree.” Higher scores indicate a higher level of perceived psychological contract fulfillment, i.e., the extent to which employees believe the organization has fulfilled its promises. The Cronbach's α coefficients for the two dimensions were 0.72 and 0.81, indicating acceptable reliability (Liu et al. 2008). In this study, the Cronbach's α coefficient for the total scale was 0.80.

2.2.3. Psychological Capital Scale

The Psychological Capital Scale, revised by Luo and He (2010), based on the context of nursing practice in China, consists of 20 items across four dimensions: hope, optimism, resilience, and self‐efficacy. The scale uses a Likert‐6 point scoring method, with scores ranging from 1 to 6 corresponding to “strongly disagree” to “strongly agree.” Total scores range from 20 to 120. Higher scores indicate higher levels of psychological capital, i.e., more positive psychological states and resources (such as hopefulness, optimism, resilience, and self‐efficacy). The Cronbach's α coefficient for the total scale was 0.92, and the coefficients for the subscales ranged from 0.72 to 0.89, indicating acceptable reliability (Luo and He 2010). In this study, the Cronbach's α coefficient was 0.93.

2.2.4. Job Performance Scale

The Job Performance Scale, revised and designed by Liang (2006), consists of 11 items across two dimensions: task performance and contextual performance. The scale uses a Likert‐5 point scoring method, with scores ranging from 1 to 5 corresponding to “strongly disagree” to “strongly agree.” Higher scores indicate higher levels of job performance, i.e., better performance in task completion and collaborative behaviors. The Cronbach's α coefficient for the total scale was 0.819, and the coefficients for the two dimensions were 0.74 and 0.75, indicating acceptable reliability (Liang 2006). In this study, the Cronbach's α coefficient for the total scale was 0.85.

2.3. Ethical Considerations

This study employed an anonymous survey design and involved no interventions that could harm participants’ physical or psychological well‐being. Ethical principles were strictly observed throughout the research process. Prior to data collection, all investigators received standardized training to ensure consistency in survey administration. Approval was obtained from hospital administrators and nursing departments. This study was approved by the Biomedical Ethics Committee of Henan University (Approval No.: HUSOM2023‐478). Eligible nurses were invited to participate through internal hospital communication systems. Each participant received a sealed envelope containing the questionnaire, a written informed consent form, and a written explanation of the study. Researchers clearly explained the study's purpose, procedures, confidentiality measures, and participants’ rights. Participation was voluntary, and all participants provided written informed consent before enrolment. They were informed of their right to withdraw at any time without consequences. No inducements or pressure were applied during data collection. All data were used solely for academic research and were securely stored. The study adhered to the principles of the Declaration of Helsinki.

2.4. Research Procedure and Statistical Analysis

Data were analyzed and processed using IBM SPSS 27.0 and AMOS 26.0. First, common method bias (CMB) was examined using Harman's single‐factor test. Second, the demographic characteristics of the participants were described using frequencies and percentages. The Kolmogorov–Smirnov test was used to assess the normality of the four continuous variables: psychological contract, turnover intention, psychological capital, and job performance. The results showed that the distributions of the variables were approximately normal. Accordingly, Pearson correlation analysis was used to examine the relationships among the variables. Subsequently, a structural equation model (SEM) was constructed using AMOS 26.0, with psychological contract as the independent variable, turnover intention as the dependent variable, and psychological capital and job performance as mediators. Finally, a bootstrapping procedure with 2,000 resamples was used to calculate multiple mediation effects and bias‐corrected confidence intervals (CIs). A significant mediation effect was determined if the 95% CI did not include 0. A two‐tailed p‐value < 0.05 was considered statistically significant. Given the cross‐sectional design of the study, the SEM tested hypothesized directional associations rather than causal relationships.

3. Results

3.1. CMB Test

Because all variables in this study were self‐reported, it was necessary to examine whether CMB existed. CMB is typically controlled using procedural and statistical methods. In terms of procedural control, the questionnaire included reverse‐scored items, adopted different scoring formats (4‐point, 5‐point, and 6‐point scales), and emphasized anonymity and confidentiality, explaining that the data would be used solely for scientific research. In terms of statistical control, Harman's single‐factor test was performed by subjecting all items to an unrotated principal component factor analysis. The results showed seven factors with eigenvalues greater than 1, and the first factor explained 39.746% of the total variance, which is below the 40% threshold (Podsakoff et al. 2003). These findings suggest that CMB was unlikely to fully account for the observed relationships.

3.2. Demographic Characteristics of Participants

A total of 789 young nurses participated in this study. Among them, 585 (74.1%) were female and 204 (25.9%) were male. The majority of participants were aged 24–29 years (45.3%). Most were unmarried (80.9%). The average monthly income was predominantly 4,000–7,000 RMB (59.0%), the average daily working hours were mostly 7–8 hours (61.7%), and the number of night shifts per month was mainly 5–8 (45.0%). Details are presented in Table 1.

TABLE 1.

Characteristics of participants (N = 789).

Demographics N (%)
Gender
Man 204 (25.9)
Female 585 (74.1)
Age, years
<24 353 (44.7)
24–29 357 (45.3)
>29 79 (10.0)
Marital status
Unmarried 638 (80.9)
Married 143 (18.1)
Divorced 8 (1.0)
Highest education
College or below 168 (21.3)
Bachelor degree 510 (64.6)
Master's degree or above 111 (14.1)
Average monthly income
≤4000 203 (25.7)
4000–7000 465 (59.0)
7000–10,000 79 (10.0)
≥10,001 42 (5.3)
The average daily working time was
<7 hours 194 (24.6)
7–8 hours 487 (61.7)
≥9 hours 108 (13.7)
The average number of night shifts per month
≤4 times 286 (36.2)
5–8 times 355 (45.0)
≥9 times 148 (18.8)
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3.3. Correlation Analysis and Significance Test

Based on the normality test results, correlation analyses were performed among the four variables (see Table 2). The mean item score for turnover intention among young nurses was moderately high (14.98 ± 4.353). Turnover intention was significantly negatively correlated with psychological contract (r = –0.781, p = 0.01), psychological capital (r = –0.827, p = 0.01), and job performance (r = –0.793, p = 0.01). According to the effect size criteria proposed by Cohen (1988) and Ferguson (2009), correlation coefficients of 0.10, 0.30, and 0.50 correspond to small, medium, and large effect sizes, respectively. All correlation coefficients in this study exceeded 0.50. Regarding the relatively high correlations among variables, multicollinearity diagnostics were performed. A linear regression analysis was conducted with psychological contract, psychological capital, and job performance as predictors and turnover intention as the dependent variable. The results showed that the variance inflation factors (VIFs) for all predictors were below 5 (psychological contract VIF = 3.153, job performance VIF = 3.387, psychological capital VIF = 4.474), far below the common threshold of 10, indicating sufficient discriminant validity among the three constructs. Model diagnostics indicated that multicollinearity did not compromise the stability or interpretability of the parameter estimates.

TABLE 2.

Descriptive statistics and correlations among the study variables (N=789).

TI PC PSC JP Mean SD
TI — 14.980 4.353
PC −0.781 ** — 28.230 7.384
PSC −0.827 ** 0.817 ** — 66.230 20.898
JP −0.793 ** 0.748 ** 0.831 ** — 35.150 10.369
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TI, Turnover intention; PC, Psychological contract; PSC, Psychological capital; JP, Job performance.

**

p < 0.01 (two‐tailed).

3.4. Mediation Effect Analysis

A SEM was used to examine the mediating roles of psychological capital and job performance in the relationship between psychological contract and turnover intention among young nurses. The model fit indices indicated a good fit (see Table 3), meeting the criteria recommended by Hu and Bentler (1999): χ2/df = 2.466, RMSEA = 0.043, GFI = 0.980, CFI = 0.996, TLI = 0.994, and IFI = 0.996.

TABLE 3.

SEM fitting index.

Model PCMIN/DF RMSEA GFI CFI TLI IFI
Recommended value <5 <0.08 >0.90 >0.90 >0.90 >0.90
Mediation model 2.466 0.043 0.98 0.996 0.994 0.996
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CMIN/DF, the Χ 2 divided by degrees of freedom; RMSEA, root mean square error of approximation; GFI, the goodness‐of‐fit index; CFI, the comparative fit index; TLI, Tucker–Lewis Index; IFI, incremental fit index.

As illustrated in Figure 1, psychological contract was significantly positively associated with psychological capital (β = 0.87, p < 0.001) and with job performance (β = 0.27, p < 0.001), and significantly negatively associated with turnover intention (β = –0.29, p < 0.001). Psychological capital was significantly positively associated with job performance (β = 0.64, p < 0.001) and significantly negatively associated with turnover intention (β = –0.31, p < 0.001). Job performance was significantly negatively associated with turnover intention (β = –0.38, p < 0.001).

FIGURE 1.

FIGURE 1

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Path analysis diagram of turnover intention, psychological contract, psychological capital, and job performance. TI: turnover intention; TI‐A: turnover dimension 1; TI‐B: turnover dimension 2; TI‐C: turnover dimension 3; PC: psychological contract; PC‐O: performance‐based obligation; PC‐L: loyalty; PSC: psychological capital; PSC‐H: hope; PSC‐O: optimism; PSC‐E: elasticity; PSC‐T: self‐efficacy; JP: job performance; JP‐TP: task performance; JP‐CP: contextual performance.

To further examine the mediating roles of psychological capital and job performance, a bootstrapping procedure with bias‐corrected percentiles and 2,000 resamples was used to determine the 95% CIs. The results showed that psychological capital partially mediated the relationship between psychological contract and turnover intention, with an effect value of –0.268 (95% CI: [–0.360, –0.175]). Job performance also partially mediated this relationship, with an effect value of –0.102 (95% CI: [–0.166, –0.055]). Furthermore, a chain mediating effect of psychological capital and job performance was found between psychological contract and turnover intention, with an effect value of –0.213 (95% CI: [–0.292, –0.150]), accounting for approximately one quarter of the total indirect association. The specific path coefficients and effect values are presented in Table 4.

TABLE 4.

Bootstrap analysis of the mediating model.

Effects Paths Effect Bootstrap SE Bias‐corrected 95%CI
Total effect PC→TI −0.876 0.016 −0.906 to −0.844
Direct effect PSC→TI −0.293 0.053 −0.406 to −0.199
Indirect effect PC→PSC→JP→TI −0.213 0.037 −0.292 to −0.150
PC→JP→TI −0.102 0.027 −0.166 to −0.055
PC→PSC→TI −0.268 0.046 −0.360 to −0.175
Total indirect effect Total indirect effect −0.583 0.043 −0.662 to −0.492
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Abbreviations: TI, Turnover intention, PC, Psychological contract, PSC, Psychological capital, JP, Job performance.

4. Discussion

4.1. Associations of Psychological Contract, Psychological Capital, and Job Performance With Turnover Intention Among Young Nurses

This study explored the associations among psychological contract, psychological capital, job performance, and turnover intention in young nurses. The results showed that the mean turnover intention score among young nurses (14.98 ± 4.353) was consistent with the generally high level of turnover intention reported in recent international studies (Slater et al. 2021; Wei et al. 2021). In the Chinese context, this study verified that psychological contract was negatively associated with turnover intention among young nurses (β = –0.29, p = 0.001), which aligns with previous findings (Sheehan et al. 2019). The underlying reason is that fulfillment of the organizational psychological contract is key to maintaining workforce stability: when young nurses’ expectations regarding compensation, career development, and organizational respect are met, they are more likely to align their personal goals with organizational development, which is associated with lower turnover intention (Li 2024). Conversely, if hospital management practices are insufficiently scientific and neglect young nurses’ career growth needs, leading to a perceived imbalance between effort and rewards (e.g., salary, benefits, and promotion opportunities), this may be accompanied by a lower level of psychological contract, which in turn is associated with decreased job satisfaction and negative work behaviors (such as tardiness, absenteeism, and diminished work enthusiasm), ultimately relating to higher turnover intention.

The results of this study indicated that psychological capital partially mediated the relationship between psychological contract and turnover intention among young nurses (indirect effect = –0.268; 95% CI, [–0.360, –0.175]), supporting Hypothesis 2. In the Chinese nursing context, nurses often face high workloads and occupational stress (Dai 2023), which underscores the importance of psychological capital as a positive psychological resource. When the psychological contract is well fulfilled, nurses perceive organizational support, fairness, and respect, and this positive experience helps enhance their psychological capital (Lu et al. 2023). Psychological capital encompasses self‐efficacy, optimism, hope, and resilience, and is considered an important psychological buffer for young nurses in coping with work stress (Dhiman and Arora 2020; Okros and Vîrgă 2022). Young nurses with higher levels of psychological capital, owing to greater resilience, optimism, and self‐efficacy, are more inclined to proactively cope with work challenges, which is associated with more stable professional commitment (Xiao et al. 2022). In contrast, nurses with lower psychological capital are more likely to adopt negative avoidance strategies when facing difficulties, which is associated with depletion of psychological resources and ultimately relates to higher turnover intention (Yektatalab et al. 2020).

The results of this study also showed that job performance partially mediated the relationship between psychological contract and turnover intention among young nurses (indirect effect = –0.102; 95% CI, [–0.166, –0.055]), supporting Hypothesis 3. The underlying logic is that when the psychological contract is fulfilled, nurses are more likely to perceive a balance between effort and reward, which is associated with increased intrinsic motivation and work engagement, and in turn with higher performance (Yu 2022). Improved job performance makes it easier for nurses to receive organizational recognition and corresponding rewards (e.g., promotion and incentives), which is associated with higher professional commitment, thereby forming a virtuous cycle of “psychological contract—performance—retention” (Wang et al. 2022). This finding aligns with the practical logic that nurses’ job performance is closely related to patient care quality (Chen et al. 2019) and is also highly consistent with the policy orientation of the National Nursing Development Plan (2021–2025), which emphasizes “stabilizing the nursing workforce through performance incentives” (Commission 2022), thereby providing support for achieving the dual goals of workforce stability and service quality improvement.

This study found that psychological capital and job performance served a chain mediating role between psychological contract and turnover intention among young nurses (indirect effect = –0.213), supporting Hypothesis 4. Examining the relationships among the variables, fulfillment of the psychological contract is associated with higher levels of psychological capital; individuals with high psychological capital, leveraging their positive psychological resources, are more inclined to proactively cope with work challenges, which in turn is associated with higher job performance (Okros and Vîrgă 2022). The organizational recognition and rewards resulting from improved performance are associated with higher retention intention, forming a sustained positive cycle (Wang et al. 2022). Theoretically, this chain mediation extends the understanding of how psychological contract operates, revealing the internal logic through which it relates to turnover intention via a sequential “psychological–behavioral” pathway. Practically, given the high turnover rate among young nurses in China, single‐component interventions have limited effects. It is recommended to establish a comprehensive management model of “contract fulfilment—psychological empowerment—performance recognition” to provide a systematic approach for enhancing the overall stability and work effectiveness of the nursing workforce.

4.2. Implications for Nursing and Health Policy

This study provides actionable management and policy implications for stabilizing the young nursing workforce. At the nursing management level, healthcare institutions should effectively fulfill the psychological contract with young nurses by optimizing the practice environment, improving compensation, benefits, and career development pathways, thereby enhancing organizational belonging (Lu et al. 2023). Concurrently, psychological capital should be cultivated through systematic training, psychological counseling, and other means. A multidimensional performance management system should be established, and the linkage between performance appraisal results and incentives should be strengthened to indirectly reduce turnover intention (Yan et al. 2021). At the policy level, it is recommended that psychological contract and psychological capital be incorporated as core indicators in nursing human resources planning and occupational health assessments (Lu et al. 2023). Health authorities may establish special funds to support hospitals in implementing retention intervention programs and to build an integrated “hospital–community–family” support network. In nursing education, greater emphasis should be placed on cultivating students’ professional psychological literacy and contract awareness, thereby enhancing their psychological capital and organizational adaptability from the outset and laying the foundation for reducing future turnover risk (Wu et al. 2022). Furthermore, salary protection and career development systems for nurses should be improved, and a social atmosphere that respects the nursing profession should be fostered, providing a locally grounded practical reference for addressing the global nursing shortage.

4.3. Study Limitations and Future Directions

Although this study has theoretical and practical value, several limitations should be acknowledged. First, the cross‐sectional design can only analyze associations among variables and cannot reveal dynamic evolution patterns or establish causal relationships. Future research using longitudinal designs is needed to further investigate these issues. Second, the data relied on self‐reports, which may be subject to recall bias. Furthermore, as job performance was assessed using self‐reported measures, it may reflect perceived rather than objectively evaluated performance. Future studies could combine qualitative interviews and third‐party evaluations to enhance data authenticity. Third, the relatively high pairwise correlations among psychological contract, psychological capital, and job performance observed in this study suggest potential conceptual overlap or unclear boundaries among these constructs. Although multicollinearity diagnostics confirmed the discriminant validity of the constructs, the high correlations may still have potential implications for the interpretation of the findings. Finally, although the CMB test results in this study were within an acceptable range, the relevant indices approached the recommended threshold. Therefore, the potential influence of CMB on the results cannot be completely ruled out. Future research is advised to adopt multi‐source, multi‐time‐point data collection designs to further control for this methodological bias.

5. Conclusion

This study confirmed a significant direct negative association between psychological contract and turnover intention among young nurses, with psychological capital and job performance serving a chain mediating role. These findings address the global challenge of nursing shortages while providing empirical evidence to reduce high turnover rates in this population. Accordingly, hospital managers and policymakers can implement integrated intervention strategies—including strengthening psychological contract fulfillment, systematically cultivating psychological capital, and optimizing performance incentive systems—to effectively lower turnover intention and promote workforce stability. Although this study was conducted within the Chinese healthcare context, the identified psychological patterns may be relevant to other health systems facing high early‐career nurse attrition.

Author Contributions

ZM conceived the study, conducted the investigation, curated the data, performed formal analysis, and wrote the original draft. HQ contributed to the original draft, data curation, and formal analysis. DL reviewed and edited the manuscript, conducted investigation, and provided resources. JJ wrote parts of the original draft and contributed to data curation and formal analysis. YF reviewed and edited the manuscript, curated data, and validated results. GL reviewed and edited the manuscript, performed formal analysis, and oversaw project administration and funding acquisition. CC supervised the study, designed the methodology, reviewed and edited the manuscript, conducted formal analysis, and managed project administration and funding. All authors read and approved the final manuscript.

Funding

This work was supported by ① Soft Science Research Project of Henan Provincial Department of Science and Technology (No. 242400410523); ② Special Research Project for the Construction of a Strong Education Province in Henan Province (No. 2026JYQS073); ③ Henan Provincial Medical Science and Technology Tackling Program (No. RKX202402028).

Conflicts of Interest

No conflict of interest has been declared by the authors.

Acknowledgment

The authors would like to thank all the participants of the study.

Data Availability Statement

The data sets used and during the current study are available from the corresponding author on reasonable request.

References

  1. Alev, S. , and Bozbayindir F.. 2021. “Examination of the Relationships between the Psychological Contract, Organisational Cynicism, and Turnover Intention.” Eurasian Journal of Educational Research. 10.14689/ejer.2021.92.5. [DOI] [Google Scholar]
  2. Bernardin, J. , Russell J. E. A., and Tyser R. J.. 1997. Human Resource Management: An Experiential Approach. Irwin Professional Pub. [Google Scholar]
  3. Chen, F. L. , Chen K.‐C., Chiou S.‐Y., Chen P. Y., Du M.‐L., and Tung T.‐H.. 2019. “The Longitudinal Study for the Work‐Related Factors to Job Performance Among Nurses in Emergency Department.” Medicine 98, no. 12: e14950. 10.1097/md.0000000000014950. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Chen, G. , Sang L., Rong J., et al. 2021. “Current Status and Related Factors of Turnover Intention of Primary Medical Staff in Anhui Province, China: A Cross‐Sectional Study.” Human Resources for Health 19: 23. 10.1186/s12960-021-00563-6. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Chen, M. , Mi X., Xue J., Li Y.i, and Shi J.. 2023. “The Impact of Entrepreneurial Team Psychological Capital on Innovation Performance: The Mediating Role of Knowledge Sharing and Knowledge Hiding.” Frontiers in Psychology 14: 1133270. 10.3389/fpsyg.2023.1133270. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Cohen, J. 1988. Statistical Power Analysis for the Behavioral Sciences (2nd ed.). Statistical Power Analysis for the Behavioral Sciences. 10.4324/9780203771587. [DOI] [Google Scholar]
  7. Commission, N. H . 2022. National Nursing Development Plan (2021–2025) . Retrieved from https://www.gov.cn/zhengce/zhengceku/2022‐05/09/content_5689354.htm.
  8. Dai, S. T. 2023. “Current Status and Influencing Factors of Turnover Intention of Male Nurses in a Regional Class III Grade a Hospital.” 10.27691/d.cnki.gcdyx.2023.000249. [DOI]
  9. Danial, M. , and Nasir Q.. 2020. “Effect of Psychological Contract on Employee's Performance With Employee Engagement as Mediator.” Journal of Research in Psychology 2: 24–34. 10.31580/jrp.v2i2.1568. [DOI] [Google Scholar]
  10. Dhiman, N. , and Arora N.. 2020. “Influence of Psychological Capital on Turnover Intentions: Empirical Evidence From Indian Paramedics.” International Journal of Work Innovation 2, no. 4: 247. 10.1504/IJWI.2020.111745. [DOI] [Google Scholar]
  11. Dwyer, P. A. , Hunter Revell S. M., Sethares K. A., and Ayotte B. J.. 2019. “The Influence of Psychological Capital, Authentic Leadership in Preceptors, and Structural Empowerment on New Graduate Nurse Burnout and Turnover Intent.” Applied Nursing Research 48: 37–44. 10.1016/j.apnr.2019.04.005. [DOI] [PubMed] [Google Scholar]
  12. Ferguson, C. J. 2009. “An Effect Size Primer: A Guide for Clinicians and Researchers.” Professional Psychology: Research and Practice 40: 532–538. 10.1037/a0015808. [DOI] [Google Scholar]
  13. He, Z. , Chen L., and Shafait Z.. 2023. “How Psychological Contract Violation Impacts Turnover Intentions of Knowledge Workers? The Moderating Effect of Job Embeddedness.” Heliyon 9, no. 3: e14409. 10.1016/j.heliyon.2023.e14409. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Hu, L. T. , and Bentler P. M.. 1999. “Cutoff Criteria for Fit Indexes in Covariance Structure Analysis: Conventional Criteria Versus New Alternatives.” Structural Equation Modeling: A Multidisciplinary Journal 6, no. 1: 1–55. 10.1080/10705519909540118. [DOI] [Google Scholar]
  15. Huang, S. S. , Yu Z., Shao Y., YuCorresponding M., and Li Z.. 2020. “Relative Effects of Human Capital, Social Capital and Psychological Capital on Hotel Employees' Job Performance.” International Journal of Contemporary Hospitality Management 33, no. 2: 490–512. 10.1108/IJCHM-07-2020-0650. [DOI] [Google Scholar]
  16. Hui, Z. 2021. “Corporate Social Responsibilities, Psychological Contracts and Employee Turnover Intention of SMEs in China.” Frontiers in Psychology 12: 754183. 10.3389/fpsyg.2021.754183. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Jiang, Z. , Su Y., Meng R., Lu G., Liu J., and Chen C.. 2024. “The Effects of Work Readiness, Organizational Justice and Professional Identity on the Work Performance of New Nurses: A Cross‐Sectional Survey.” BMC Nursing 23, no. 1: 759. 10.1186/s12912-024-02420-y. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Li, J. Y. , and Li D. R.. 2003. “Correlation Study of Role Conflict, Organizational Commitment and Turnover Intention Under Matrix Organizational Structure: A Case Study of Employees in Industrial Technology Research Institute.” Chinese Journal of Management 4, no. 1: 24. 10.30053/CHJM.200303.0002. [DOI] [Google Scholar]
  19. Li, L. 2024. “Study on the Relationship Between Rights Protection, Job Burnout and Turnover Intention of ICU Nurses.” 10.27913/d.cnki.ghyby.2024.000216. [DOI]
  20. Liang, Y. 2006. “Study on the Relationship Between Job Satisfaction and Job Performance of Employees in State‐Owned Enterprises.” 10.7666/d.y1019777. [DOI]
  21. Ling, C. , Tao L., Wang X., Wu Y., Chai Y., and Zhang L.. 2024. “Analysis of Turnover Intention and Influencing Factors Among Female Nurses with Two Children in Grade A Tertiary Public Hospitals in Sichuan Province: A Cross‐Sectional Study.” Frontiers in Public Health 12: 1416215. 10.3389/fpubh.2024.1416215. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Liu, C. 2024. “An Empirical Study on Employee Innovation Promotion from the Perspective of Psychological Contract.” 10.27667/d.cnki.gzymu.2024.000159. [DOI]
  23. Liu, X. Y. , Liu J., and Yu G. T.. 2008. “Preemployment Beliefs, Organizational Inducement, and Psychological Contract Change: A Longitudinal Study.” Journal of Psychology 40, no. 1: 10. 10.3724/SP.J.1041.2008.00064. [DOI] [Google Scholar]
  24. Lu, X. , Yang J., Bai D., et al. 2023. “The Effect of Psychological Contract on Turnover Intention Among Nurses: A Meta‐Analytic Review.” BMC Nursing 22, no. 1: 358. 10.1186/s12912-023-01496-2. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Luo, H. , and He Z. H.. 2010. “To Analyze the Reliability and Validity of Psychological Capital Questionnaire in Nurses.” Chinese Journal of Behavioral Medicine and Brain Science 19, no. 9: 2. 10.3760/cma.j.issn.1674-6554.2010.09.028. [DOI] [Google Scholar]
  26. Luthans, F. , Youssef‐Morgan C., and Avolio B.. 2007. Psychological Capital: Developing the Human Competitive Edge. 10.1093/acprof:oso/9780195187526.001.0001. [DOI] [Google Scholar]
  27. McDermid, F. , and Peters K.. 2020. “Factors Contributing to High Turnover Rates of Emergency Nurses: A Review of the Literature.” Australian Critical Care 33, no. 4: 390–396. 10.1016/j.aucc.2019.09.002. [DOI] [PubMed] [Google Scholar]
  28. Michaels, C. E. , and Spector P. E.. 1982. “Causes of Employee Turnover: A Test of the Mobley, Griffeth, Hand, and Meglino Model.” Journal of Applied Psychology 67, no. 1: 53–59. 10.1037/0021-9010.67.1.53. [DOI] [Google Scholar]
  29. Mobley, W. H. 1977. “Intermediate Linkages in the Relationship Between Job Satisfaction and Employee Turnover.” Journal of Applied Psychology 62, no. 2: 237–240. 10.1037/0021-9010.62.2.237. [DOI] [Google Scholar]
  30. Okros, N. , and Vîrgă D.. 2022. “How to Increase Job Satisfaction and Performance? Start With Thriving: The Serial Mediation Effect of Psychological Capital and Burnout.” International Journal of Environmental Research and Public Health 19, no. 13: 8067. 10.3390/ijerph19138067. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Paliga, M. , Kożusznik B., Pollak A., and Sanecka E.lż. 2022. “The Relationships of Psychological Capital and Influence Regulation with Job Satisfaction and Job Performance.” PLoS ONE 17: e0272412. 10.1371/journal.pone.0272412. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Podsakoff, P. M. , MacKenzie S. B., Lee J. Y., and Podsakoff N. P.. 2003. “Common Method Biases in Behavioral Research: A Critical Review of the Literature and Recommended Remedies.” Journal of Applied Psychology 88, no. 5: 879–903. 10.1037/0021-9010.88.5.879. [DOI] [PubMed] [Google Scholar]
  33. Rousseau, D. M. 1989. “Psychological and Implied Contracts in Organizations.” Employee Responsibilities and Rights Journal 2, no. 2: 121–139. 10.1007/BF01384942. [DOI] [Google Scholar]
  34. Sheehan, C. , Tham T. L., Holland P., and Cooper B.. 2019. “Psychological Contract Fulfilment, Engagement and Nurse Professional Turnover Intention.” International Journal of Manpower 40, no. 1: 2–16. 10.1108/IJM-08-2017-0211. [DOI] [Google Scholar]
  35. Slater, P. , Roos M., Eskola S., et al. 2021. “Challenging and Redesigning a New Model to Explain Intention to Leave Nursing.” Scandinavian Journal of Caring Sciences 35, no. 2: 626–635. 10.1111/scs.12884. [DOI] [PubMed] [Google Scholar]
  36. Sun, L. X. 2013. “Random Sampling Design of Multistage Cluster Sampling in Overall Network Analysis.” Statistics and Decision Making, no. 6: 24–26. 10.13546/j.cnki.tjyjc.2013.06.005. [DOI] [Google Scholar]
  37. Topa, G. , Aranda‐Carmena M., and De‐Maria B.. 2022. “Psychological Contract Breach and Outcomes: A Systematic Review of Reviews.” International Journal of Environmental Research and Public Health 19, no. 23: 15527. 10.3390/ijerph192315527. [DOI] [PMC free article] [PubMed] [Google Scholar]
  38. Wang, C.‐Y. , Lin Y.‐K., Chen I.‐H., Wang C.‐S., Peters K., and Lin S.‐H.. 2022. “Mediating Effect of Job Performance Between Emotional Intelligence and Turnover Intentions Among Hospital Nurses During the COVID‐19 Pandemic: A Path Analysis.” Collegian 30: 247–253. 10.1016/j.colegn.2022.09.006. [DOI] [PMC free article] [PubMed] [Google Scholar]
  39. Wei, W. , Gan M., Liu Y., Yang M., and Liu J.. 2021. “Mediating Effects of Nurses 'Personal and Organizational Values Between Organizational Commitment and Turnover: Cross‐Sectional Study.” PLoS ONE 16, no. 10: e0258387. 10.1371/journal.pone.0258387. [DOI] [PMC free article] [PubMed] [Google Scholar]
  40. Weidi, J. 2020. “Research on turnover intention of teachers in private colleges [Master's Degree].” 10.27307/d.cnki.gsjtu.2020.003844. [DOI]
  41. WHO . 2010. Global Strategy on Human Resources for Health: Workforce, WHO; 2030. [Google Scholar]
  42. Widyanty, W. , and Prasetya P.. 2023. “Turnover Intention in Healthcare Workers: An Investigation of Work Environment, Employee Performance, and Work Satisfaction Us Mediating Role.” Jurnal Ilmiah Manajemen dan Bisnis 9, no. 1: 101–116. 10.22441/jimb.v9i1.19031. [DOI] [Google Scholar]
  43. Wu, Y.u‐P. , Ahorsu D. K., Chen J.‐S., Lee C.‐H., Lin C.‐Y., and Griffiths M. D.. 2022. “The Role of Demographic Factors, Mindfulness and Perceived Stress in Resilience Among Nurses: A Cross Sectional Study.” Journal of Nursing Management 30, no. 7: 3093–3101. 10.1111/jonm.13715. [DOI] [PubMed] [Google Scholar]
  44. Xiao, S. , Shi L., Lin H., et al. 2022. “The Impact of Psychological Capital on Turnover Intention Among Chinese Nurses: A Moderated Mediation Model.” Journal of Nursing Management 30, no. 7: 3031–3040. 10.1111/jonm.13702. [DOI] [PubMed] [Google Scholar]
  45. Xu, Y. , Zhan N., Zhang D., Xie Z., Li G., and Huang H.. 2024. “The Effect of Sense of Security on Job Performance of Medical Staff: The Mediating Effect of Psychological Capital.” Frontiers in Psychology 15: 1347783. 10.3389/fpsyg.2024.1347783. [DOI] [PMC free article] [PubMed] [Google Scholar]
  46. Yan, Z. , Mansor Z. D., Choo W. C., and Abdullah A. R.. 2021. “How to Reduce Employees' Turnover Intention From the Psychological Perspective: A Mediated Moderation Model.” Psychology Research and Behavior Management 14: 185–197. 10.2147/prbm.S293839. [DOI] [PMC free article] [PubMed] [Google Scholar]
  47. Yektatalab, S. , Honarmandnejad K., Janghorban R., and Zarifsanaiey N.. 2020. “Effect of Web‐Based Life Skills Education on Nurses' Job Burnout.” Turkish Online Journal of Distance Education 21, no. 1: 37–46. 10.17718/tojde.727974. [DOI] [Google Scholar]
  48. Yu, J. 2022. “Impacts of Psychological Contract Fulfillment on Work Attitudes and Behaviors During the COVID‐19 Pandemic: Mediating Role of Perceived Organizational Support.” Current Psychology 43: 14851–14860. 10.1007/s12144-022-03746-z. [DOI] [PMC free article] [PubMed] [Google Scholar]
  49. Zheng, X. , Song J., Shi X., et al. 2025. “The Effect of Professional Identity on New Nurses' Turnover Intention: The Mediating Role of Psychological Capital and Achievement Motivation.” BMC Psychology 13, no. 1: 924. 10.1186/s40359-025-03295-7. [DOI] [PMC free article] [PubMed] [Google Scholar]
  50. Zheng, X. , Song J., Shi X., Kan C., and Chen C.. 2025. “The Effect of Authoritarian Leadership on Young Nurses' Burnout: The Mediating Role of Organizational Climate and Psychological Capital.” BMC Health Services Research 25, no. 1: 292. 10.1186/s12913-025-12403-7. [DOI] [PMC free article] [PubMed] [Google Scholar]

Associated Data

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

Data Availability Statement

The data sets used and during the current study are available from the corresponding author on reasonable request.

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