Evidence map›Paper›PMID 41588459›Full record

SynthesisScandinavian journal of trauma, resuscitation and emergency medicine2026

Turnover intention and its predictors among Emergency Medical Services (EMS) professionals: a systematic review and meta-analysis.

Ehsan Zarei, Mehdi Safari, Zahra Zamani, Edris Kakemam

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Scandinavian journal of trauma, resuscitation and emergency medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Ehsan ZareiResearch Institute for Health Sciences and Environment, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Zarei_1980@yahoo.com.
Mehdi SafariDepartment of Disasters and Emergencies, School of Public Health and Safety Shahid, Beheshti University of Medical Sciences, Tehran, Iran.
Zahra ZamaniDepartment of Health Policy and Management, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Edris KakemamNon-Communicable Diseases Research Center, Research Institute for Prevention Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHigh turnover intention among pre-hospital Emergency Medical Services (EMS) professionals threatens the sustainability of these vital health services. This study aimed to determine the global prevalence of turnover intention and identify its predictive factors to inform effective retention strategies.

methodsThis systematic review and meta-analysis followed the PRISMA 2020 guidelines. The PubMed, Web of Science, and Scopus databases were comprehensively searched up to August 31, 2025. Observational studies reporting on turnover intention and its associated factors were included. The pooled prevalence was calculated using a random-effects model, and influencing factors were analyzed within the expanded Job Demands-Resources (JD-R) framework.

resultsFrom 2,077 identified records, 27 studies with an overall sample size of 129,580 participants were eligible for the systematic review. A meta-analysis of 19 studies revealed a global pooled prevalence of turnover intention of 23.5% (95% CI: 16.6%-32.1%). The prevalence was significantly higher in studies with small sample sizes (36.4%) compared to those with large sample sizes (11.7%) (p < 0.001). The pooled prevalence also differed significantly across North America (13.4%), Europe (31.6%), and other regions (45.7%) (p < 0.001). Job dissatisfaction and job stress were the most frequently reported predictors, followed by burnout, high workload, inadequate compensation, and poor physical and mental health.

conclusionApproximately one in four EMS professionals worldwide intend to leave their job. This phenomenon is a response to the imbalance between high job demands and inadequate resources. Retaining this critical workforce requires a dual approach: strengthening resources at the organizational level and implementing structural reforms at the macro-policy level.

Indexed as

Emergency Medical ServicesIntentionJob SatisfactionPersonnel TurnoverHumansParamedicineParamedicsEmergency Medical Services (EMS)Intention to leaveParamedicPre-hospital emergency servicesTurnover intention

Identifiers

PMID41588459
PMCPMC12918125

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.