ArticleInternational journal of nursing studies advances2026
The effects of emotional exhaustion and resilience on the relationship between the practice environment and turnover intentions among acute care nurses: A moderated mediation analysis.
Article in International journal of nursing studies advances, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Nursing shortage is a complex national crisis compounded by high turnover of qualified nurses, particularly during and in the post-pandemic period. Objectives: To examine the effects of emotional exhaustion and resilience on the relationship between the practice environment and turnover intentions among acute care nurses. Design: Cross-sectional descriptive online survey study. Setting s: Acute care hospital settings in the United States. Participants: A total of 240 acute care nurses were recruited between October 2023 and April 2024. Methods: Participants completed four validated instruments: Practice Environment Scale-Nursing Work Index, Workplace Resilience Scale, Maslach Burnout Inventory-Human Service Survey for emotional exhaustion, and Anticipated Turnover Scale. Data were analyzed using moderated mediation regressions with Hayes' PROCESS macro in SPSS version 28.0. Results: Emotional exhaustion mediated the relationship between practice environment and turnover intentions ( Conclusions: Emotional exhaustion is a central mechanism linking practice environment conditions to turnover intentions. Resilience functions as a preventative moderator, buffering the impact of practice environment on emotional exhaustion. Implications for clinical practice: The findings support multilevel strategies that address both work conditions and resilience to promote retention among acute care nurses.
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