Table 1.
Study characteristics and findings from included studies
| Author, country | Aim | Study design | Participants (n) | Data collection and instruments | Results | Themes derived |
|---|---|---|---|---|---|---|
| Abd-Ellatif et al. (2021), Egypt | To determine the effect of fear relating to COVID-19 on job satisfaction and turnover intention | Cross-sectional | Physicians (411) | Fear of COVID-19 Scale (FCV-19S), Job satisfaction scale/satisfaction with work scale (SWWS), Turnover intention scale (TIS-6) |
Fear of COVID-19 is positively correlated with turnover intention Job satisfaction is negatively correlated with turnover intention |
Fear of COVID-19 may contribute to turnover intention Job satisfaction may mitigate turnover intention |
| Alameddine et al. (2021a), Lebanon | To investigate the resilience levels, job satisfaction, and turnover intention of nurses | Cross-sectional | Nurses (265) | Connor-Davidson Resilience Scale (CD-RISC) | Resilience is negatively correlated with turnover intention | Resilience may mitigate turnover intention |
| Alameddine et al. (2021b), Lebanon | To determine the level of resilience in the nursing workforce and its relationship to burnout, intention to quit, and perceived COVID-19 risk | Cross-sectional | Nurses (511) | Connor-Davidson Resilience Scale (CD-RISC), Copenhagen Burnout Inventory (CBI) | Resilience is negatively correlated with turnover intention | Resilience may mitigate turnover intention |
| Alameddine et al. (2022), Lebanon | To determine the level of resilience and its relationship to burnout, job satisfaction, intention to quit, and changes in practice | Cross-sectional | Pharmacists (459) | Connor-Davidson Resilience Scale (CD-RISC) | Resilience is negatively correlated with turnover intention | Resilience may mitigate turnover intention |
| Alenazy et al. (2021), Australia/Saudi Arabia | To examine the relationship between perception of nursing practice environment (NPE), job satisfaction and intention to leave | Cross-sectional | Critical care nurses (152) |
Practice Environment Scale of the Nursing Work Index (PES-NWI), Nursing Workplace Satisfaction Questionnaire (NWSQ), Turnover Intention Scale (TIS-6) |
A positive NPE is negatively correlated with turnover intention Job satisfaction was not significantly related to turnover intention |
Positive working conditions may mitigate turnover intention |
| Al-Mansour (2021), Saudi Arabia | To investigate the association between stress, social support and turnover intention among healthcare workers | Cross-sectional |
Physicians (84) Nurses (134) Paramedical workers (84) Administrative staff (209) |
Perceived Stress Scale-10 (PSS-10), Multidimensional Scale of Perceived Social Support (MSPSS) | Stress is positively correlated with turnover intention, with social support acting as a mediating factor |
Stress and anxiety may contribute to turnover intention Social support may mitigate turnover intention |
| Blake et al. (2020), United Kingdom | To determine the effectiveness of well-being centres on employee well-being | Cross-sectional | Hospital employees (819) | Warwick Edinburgh Mental Well-being Scale (WEMWBS), Utrecht Work Engagement Scale (UWES-9) | There is no significant association between turnover intention and well-being centre access | The relationship between organisational support and turnover intention is inconclusive |
| Cimarolli et al. (2021), United States of America | To investigate the mediating role of employer communication and staff preparedness on turnover intention | Cross-sectional | Nursing home staff (1,683) | Questionnaires |
Higher levels of COVID-19-related challenges are positively correlated with turnover intention Quality employer communication is indirectly and negatively associated with turnover intention, with job preparedness acting as a mediating factor |
Fear of COVID-19 may contribute to turnover intention Organisational support may mitigate turnover intention |
| Cole et al. (2021), United States of America | To investigate if anxiety and stress from COVID-19 working conditions contribute to turnover intention | Cross-sectional | Nurses (111) | Questionnaires |
Married and senior nurses are more likely to experience turnover intention Psychological stress and anxiety are positively correlated with turnover intention |
Personal demographics may affect turnover intention Stress and anxiety may contribute to turnover intention |
| Cornish et al. (2021), Australia | To explore the intentions of emergency nurses to remain in or leave emergency nursing after the first year of the COVID-19 pandemic | Cross-sectional | Emergency nurses (398) | Questionnaires |
Nurses who received COVID positive patients were more likely to experience turnover intention Nurses who did not feel connected to their colleagues, team or organisation were more likely to experience turnover intention |
Fear of COVID-19 may contribute to turnover intention A lack of organisational support and social support may contribute to turnover intention |
| De los Santos and Labrague (2021), Philippines | To assess the impact of fear of COVID-19 on job stress and turnover intention among community nurses | Cross-sectional | Community nurses (385) |
Fear of COVID-19 Scale (FCV-19S), Job Satisfaction Index (JSI), Job Stress Scale (JSS) |
Fear of COVID-19 is positively correlated with turnover intention | Fear of COVID-19 may contribute to turnover intention |
| Elhanafy and El Hessewi (2021), Egypt | Effect of fear of COVID-19 pandemic on work satisfaction and turnover intentions of nurses | Cross-sectional | Nurses (210) |
Fear of COVID-19 scale (FCV-19S), Job Satisfaction Index (JSI) |
Fear of COVID-19 is positively correlated with turnover intention | Fear of COVID-19 may contribute to turnover intention |
| Fisher et al. (2021), United States of America | To explore factors that influenced the personal and professional well-being of care providers working in long-term care facilities | Qualitative descriptive |
Certified nursing assistants (8) Nurses (4) Other (2) |
Semi-structured interview | Workplace stressors such as high workloads and low staff morale are associated with turnover intention | Difficult working conditions may contribute to turnover intention |
| Fronda and Labrague (2022), Oman/Philippines | To examine the relationship between coronaphobia and frontline nurses’ organisational and professional turnover intention, and to assess whether social support and coping skills can buffer this relationship | Cross-sectional | Nurses (687) |
Coronavirus Anxiety Scale (CAS), Brief Coping Skills Scale (BCS), Perceived Social Support Questionnaire (PSSQ) |
Coronaphobia is positively related to turnover intention, with social support and coping skills acting as mediating factors |
Fear of COVID-19 may contribute to turnover intention Social support may mitigate turnover intention |
| Hou et al. (2021), China | To assess the prevalence of turnover intention and explored associated factors on turnover intention among healthcare workers during the COVID-19 pandemic in China | Cross-sectional |
Physicians (845) Nurses (344) Others (214) |
Depression Anxiety Stress Scale − 21 (DASS-21), Perceived Social Support (PSS) Scale |
Workers in secondary hospitals were more likely to experience turnover intention Workers with daily working hours of more than 12 h were more likely to experience turnover intention Workers who refused to volunteer for frontline roles were more likely to experience turnover intention Workers who experienced no change in patient relations were more likely to experience turnover intention Workers who experienced depression, low social support or a combination of psychosocial issues were more likely to experience turnover intention |
Difficult working conditions may contribute to turnover intention Poor mental health may contribute to turnover intention |
| Khattak et al. (2021), Pakistan | To explore the moderating effect of leadership support in the relationship between fear of COVID-19, turnover intention and psychological distress in nurses | Cross-sectional | Nurses (380) | Fear of COVID-19 Scale (FCV-19S) | Fear of COVID-19 is positively correlated with turnover intention, with leadership support acting as a mediating factor |
Fear of COVID-19 may contribute to turnover intention Organisational support may mitigate turnover intention |
| Labrague and de Los Santos (2021a), Oman/Philippines | To examine whether frontline nurses' fear of COVID-19 contributes to psychological distress, work satisfaction and intent to leave their organisation and the profession | Cross-sectional | Nurses (261) |
Fear of COVID-19 Scale (FCV-19S), Job Satisfaction Index (JSI), Job Stress Scale (JSS) |
Fear of COVID-19 is positively correlated with turnover intention | Fear of COVID-19 may contribute to turnover intention |
| Labrague and de Los Santos (2021b), Oman/Philippines | To examine the mediating role of resilience in the relationship between compassion fatigue and frontline nurses' job outcomes | Cross-sectional | Nurses (270) |
Compassion Fatigue Scale (CFS), Brief Resilient Coping Skills (BRCS) scale |
Compassion fatigue is positively correlated with turnover intention, with resilience acting as a mediating factor |
Compassion fatigue may contribute to turnover intention Resilience may mitigate turnover intention |
| Labrague et al. (2021), Oman/Philippines | To assess the influence of COVID-19-associated discrimination on frontline nurses’ mental health and their intention to quit the nursing profession with resilience acting as a mediator | Cross-sectional | Nurses (259) |
COVID-19-Associated Discrimination (CAD) scale, Brief Resilient Coping Skills (BRCS) scale, Mental Health Inventory (MHI) |
COVID-19-associated discrimination is positively correlated with turnover intention, with resilience acting as a mediating factor |
COVID-19-associated discrimination may contribute to turnover intention Resilience may mitigate turnover intention |
| Lavoie-Tremblay et al. (2021), Canada | To examine the influence of caring for COVID-19 patients on nurse’s perceptions of chronic fatigue, quality of care, satisfaction at work and intention to leave their organisation and the profession | Cross-sectional | Nurses (1705) |
Transformational Leadership scale, Occupational Fatigue Exhaustion Recovery Scale (OFER) |
High job demands and poor job resources are positively correlated with turnover intention Nurses who were infected or had team members who were infected with COVID-19 were more likely to experience turnover intention |
Difficult working conditions may contribute to turnover intention Fear of COVID-19 may contribute to turnover intention |
| Lotfi et al. (2021), Iran | To determine turnover intention among operating room nurses during the COVID-19 outbreak and its association with perceived safety climate | Cross-sectional | Operating room nurses (190) | Anticipated Turnover Scale (ATS), Safety Climate Scale (SCS) | Perceived safety climate is negatively correlated with turnover intention | A strong safety climate may mitigate turnover intention |
| Magnavita et al. (2021a), Italy | To measure the perception of organisational justice and occupational stress and how these varied in relation to external factors, such as turnover intention | Cross-sectional | Intensive care physicians (120) | Colquitt questionnaire, Siegrist effort/reward imbalance model questionnaire | Physicians who put in high effort and perceived low rewards from work were more likely to experience turnover intention |
Difficult working conditions may contribute to turnover intention A lack of organisational support may contribute to turnover intention |
| Magnavita et al. (2021b), Italy | To assess the well-being and mental health of the workers after the first 10 months of the pandemic and to evaluate the extent to which their attitude toward the pandemic had changed | Cross-sectional |
Physicians (105) Nurses (47) |
Goldberg Anxiety and Depression Scale (GADS), Sleep Condition Indicator (SCI-02) | Healthcare workers who put in high effort were more likely to experience turnover intention, with perceived rewards from work acting as a mediating factor |
Difficult working conditions may contribute to turnover intention A lack of organisational support may contribute to turnover intention |
| Majeed et al. (2021), Pakistan | To investigate the mediating role of perceived fear of COVID-19 between perceived risk of COVID-19 and turnover intention | Cross-sectional |
Nurses (103) Paramedical staff (59) Doctors (16) |
Modified Perceived Vulnerability to Disease (PVD) questionnaire, Fear of COVID-19 Scale (FCV-19S) | Perceived risk of COVID-19 is positively correlated with turnover intention, with fear of COVID-19 acting as a mediating factor | Fear of COVID-19 may contribute to turnover intention |
| Mercado et al. (2022), United States of America | To examine the association between personal, work-related and contextual factors, and stress, burnout and turnover intention among healthcare workers in the COVID-19 pandemic | Cross-sectional |
Medical staff (328) Allied health staff (379) Administrative staff (224) Others (36) |
Mindful Self-Care Scale, Mental Health Continuum Short Form (MHC-SF), Healthcare Worker Exposure Response & Outcomes (HERO) Daily Impact Index, Pandemic Experiences and Perceptions Survey, Perceived Stress Scale (PSS-4) |
Age and quality of work–life were negatively correlated with turnover intention |
Personal demographics may affect turnover intention Working conditions may affect turnover intention |
| Mirzaei et al. (2021), Iran | To evaluate the relationship between turnover intention and job stressors in nurses during the COVID-19 outbreak | Cross-sectional | Nurses (479) | Impact of Event Scale-Revised (IES-R), General Health Questionnaire (GHQ), Turnover Intention Questionnaire, Job Content Questionnaire (JCQ) |
Job stressors were positively correlated with turnover intention. Married nurses and male nurses were more likely to experience turnover intention Social support was negatively correlated with turnover intention |
Difficult working conditions may contribute to turnover intention Personal demographics may affect turnover intention Social support may mitigate turnover intention |
| Naja et al. (2021), United Arab Emirates | To examine the conditions and changes in the work environment as well as resilience and its correlates among dieticians during the COVID-19 pandemic | Cross-sectional | Dieticians (371) | Connor–Davidson Resilience Scale (CD-RISC) | Resilience is negatively correlated with turnover intention | Resilience may mitigate turnover intention |
| Nashwan et al. (2021), Qatar | To compare nurses’ turnover intentions before and during COVID-19 | Cross-sectional | Nurses (512) | Turnover Intention Scale (TIS-6) | Nurses were more likely to experience turnover intention during the COVID-19 pandemic as compared to beforehand | Fear of COVID-19 may contribute to turnover intention |
| Öğütlü et al. (2021), Turkey | To determine the relationship between stress, workload, and support in psychiatrists during the COVID-19 pandemic | Cross-sectional | Psychiatrists (217) | Copenhagen Burnout Inventory (CBI) | Burnout is positively correlated with turnover intention | Burnout may contribute to turnover intention |
| Özkan Şat et al. (2021), Turkey | To determine the relationship between nurses' exposure to violence and their professional commitment during the COVID-19 pandemic | Cross-sectional | Nurses (263) | Nursing Professional Commitment Scale (NPCS) |
Nurses who experienced workplace violence were more likely to experience turnover intention Nurses who faced an increase in working hours, increase in workload and deployment to other departments were more likely to experience turnover intention |
Difficult working conditions may contribute to turnover intention |
| Pförtner et al. (2021), Germany | To examine the relationship between long-term care managers’ intentions to quit their profession and demands that affect long-term care facilities during the COVID-19 pandemic | Cross-sectional | Long-term care facility managers (833) | Questionnaires | Increased pandemic-specific and general job demands are positively correlated with turnover intention | Difficult working conditions may contribute to turnover intention |
| Raso et al. (2021), United States of America | To describe the relationships between perceptions of the pandemic impact on nurses' intent to leave their current position and the profession | Cross-sectional | Nurses (5,088) | Questionnaires | Nurses who perceived greater pandemic impact on practice were more likely to experience turnover intention | Difficult working conditions may contribute to turnover intention |
| Riggan et al. (2021), United States of America | To assess the impact of the COVID-19 pandemic on obstetricians and gynaecologists | Mixed-methods | Obstetricians and gynaecologists (72) | Questionnaires (Likert scales & open-ended questions) | Burnout is associated with turnover intention | Burnout may contribute to turnover intention |
| Said and El-Shafei (2021), Egypt | To assess occupational stress, job satisfaction, and intent to leave among nurses dealing with suspected COVID-19 patients | Cross-sectional | Nurses (420) | Expanded Nursing Stress Scale (ENSS), Specific COVID-19-Associated Stressors (SCAS), McCloskey/Mueller Satisfaction Scale (MMSS) | Nurses with longer working hours and more night duties per week were more likely to experience turnover intention | Difficult working conditions may contribute to turnover intention |
| Schug et al. (2022), Germany | To examine the correlation between frequency and associated factors of sick leave and intention to quit among nurses | Cross-sectional | Nurses (757) |
Effort-reward imbalance scale (ERI), PHQ-2 (Patient Health Questionnaire), Generalized Anxiety Disorder 2-item (GAD-2) |
Perceived reward levels were negatively correlated with turnover intention Changing work departments during the pandemic was associated with increased turnover intention Depression levels were positively correlated with turnover intention |
A lack of organisational support may contribute to turnover intention Difficult working conditions may contribute to turnover intention High levels of depression may contribute to turnover intention |
| Shah et al. (2022), Pakistan | To identify the association between job stress state anger, emotional exhaustion and job turnover intention | Cross-sectional | Nurses (318) | Maslach Burnout Inventory-General Survey (MBI) | COVID-19-related job stress, state anger and emotional exhaustion are positively correlated with turnover intention | Burnout may contribute to turnover intention |
| Sheppard et al. (2021), United States of America | To explore the level of moral distress among nurses | Cross-sectional | Nurses (107) | Measure of Moral Distress for Health Care Professionals (MMD-HP) | Nurses who perceived greater issues with patient safety and quality and work environment were more likely to experience turnover intention | Difficult working conditions may contribute to turnover intention |
| Sklar et al. (2021), United States of America | To examine the effects of work changes on burnout and subsequent turnover intentions in mental health providers, and how job and personal resources may have buffered the extent to which work changes due to COVID-19 impacted burnout | Cross-sectional | Outpatient mental health providers (93) | Copenhagen Work Burnout Inventory, Modified Michigan Organizational Assessment Questionnaire | Work changes were indirectly positively correlated with turnover intention through burnout, with organisational trust and perceived organisational support acting as mediating factors |
Difficult working conditions may contribute to turnover intention Burnout may contribute to turnover intention Organisational support may mitigate turnover intention |
| Varasteh et al. (2021), Iran | To explore the factors affecting nurses’ intentions to leave or stay in their profession during the COVID-19 pandemic | Qualitative descriptive | Nurses (19) | Semi-structured interview |
Professional commitment was associated with reduced turnover intention Fear of COVID-19 was associated with turnover intention A positive organisational atmosphere and organisational motivation was associated with reduced turnover intention |
Professional commitment may mitigate turnover intention Fear of COVID-19 may contribute to turnover intention Organisational support may mitigate turnover intention |
| Wibowo and Paramita (2022), Indonesia | To investigate the impact of mindful and empathetic leadership on resilience and turnover intention, with self-regulation as a mediating variable | Cross-sectional | Nurses (188) | Modified Mindfulness Attention Awareness Scale (MAAS), Motivating Language Scale, Connor-Davidson Resilience Scale (CD-RISC) | Mindful leadership was associated with reduced turnover intention, with self-regulation acting as a mediating factor |
Organisational support may mitigate turnover intention Self-regulation may mitigate turnover intention |
| Wood et al. (2021), United Kingdom | To understand the experiences of advanced practice nurses during the COVID-19 pandemic in relation to safety, shortages and retention | Mixed-methods | Nurses (124) | Questionnaires (Likert scales & open-ended questions) | PPE shortages and fear of COVID-19 were both associated with turnover intention | Fear of COVID-19 may contribute to turnover intention |
| Yáñez et al. (2020), Peru | To assess the anxiety, distress, and turnover intention of healthcare workers during the COVID-19 pandemic | Cross-sectional |
Hospital technicians (80) Nurses (63) Pharmacists (63) Physicians (53) Hospital volunteers (20) Others (24) |
Generalized Anxiety Disorder (GAD-7) scale, Kessler Psychological Distress scale (K6) | Younger workers were more likely to experience turnover intention | Personal demographics may affect turnover intention |
| Yang et al. (2021), China | To elucidate the effects of workplace violence on turnover intention among Chinese health care workers, and to identify the potential mediators in this relationship | Cross-sectional | Doctors, nurses and allied health workers (1,063) | Perceived Social Support (PSS) scale, Depression Anxiety Stress Scales-21 (DASS-21) | Workplace violence was positively correlated with turnover intention, with social support and mental health acting as mediating factors |
Difficult working conditions may contribute to turnover intention Social support may mitigate turnover intention General stress and anxiety may contribute to turnover intention |