Evidence map›Paper›PMID 42377279›Full record

ArticleJournal of nursing management2026

Associations Between Stress, Psychological Capital, Well-Being, Job Burnout, and Turnover Intention Among Chinese Nurses: A National Cross-Sectional Study.

Di Liu, Chunxiao Long, Yuxuan Du, Zihan Hua, Zhihao Jia, Mengxiong Wu, Lei Shi

Abstract read
In one paragraph

Article in Journal of nursing management, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

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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

3 citing papers in PubMed.

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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

7 authors.

Di LiuSchool of Marxism, Harbin Medical University, Harbin, China, hrbmu.edu.cn.ORCID https://orcid.org/0000-0001-9268-4099
Chunxiao LongSchool of Health Management, Guangzhou Medical University, Guangzhou, China, gzhmc.edu.cn.ORCID https://orcid.org/0009-0005-7541-2346
Yuxuan DuSchool of Health Management, Harbin Medical University, Harbin, China, hrbmu.edu.cn.ORCID https://orcid.org/0009-0008-0826-0700
Zihan HuaSchool of Health Management, Harbin Medical University, Harbin, China, hrbmu.edu.cn.ORCID https://orcid.org/0009-0006-3316-9138
Zhihao JiaSchool of Health Management, Harbin Medical University, Harbin, China, hrbmu.edu.cn.ORCID https://orcid.org/0009-0006-5713-3471
Mengxiong WuHealth Publicity and Education Center of Guangdong Province, Guangzhou, China.ORCID https://orcid.org/0009-0001-9618-6326
Lei ShiSchool of Health Management, Guangzhou Medical University, Guangzhou, China, gzhmc.edu.cn.ORCID https://orcid.org/0000-0002-8924-0734

Funding

Basic and Applied Basic Research Foundation of Guangdong Province 2023A1515010902Chronic Disease Management Research Project of the National Health Commission Capacity Building and Continuing Education Center GWJJMB20210010060Guangdong Association for Science and Technology SKXRC2025206Heilongjiang Province Philosophy and Social Science Research Planning 22GLE375Key Research and Development Program of Heilongjiang 2024ZX12C04
6 · The paper itself

Abstract

backgroundThe shortage of nurses is a worldwide issue. Turnover intention among nurses plays a critical role in shaping workforce stability and healthcare service quality. The inter-relationships between stress, psychological capital, job burnout, turnover intention, and well-being in nurses have not been fully clarified and warrant further study.

aimThis study aimed to investigate how stress affects turnover intention in Chinese nurses, focusing on the serial mediation of psychological capital and job burnout and the moderation of well-being.

methodsUsing a cross-sectional study design, registered nurses were recruited from 21 hospitals in eastern, central, and western China, with 4865 valid responses collected. Stress, psychological capital, well-being, job burnout, and turnover intention were measured using validated instruments. Associations among the variables were examined using a moderated serial mediation model (PROCESS Model 91), adjusting for demographic and occupational covariates.

resultsStress was positively associated with turnover intention (r = 0.380, p < 0.01) and job burnout (r = 0.568, p < 0.01) but negatively associated with psychological capital (r = -0.374, p < 0.01) and well-being (r = -0.477, p < 0.01). Stress had a significant total effect on turnover intention (c = 0.290, p < 0.001), of which the direct effect (c' = 0.142, p < 0.001) accounted for 48.97% of the total effect. Psychological capital and job burnout significantly mediated this relationship. Specifically, the indirect effect through psychological capital was 0.016, accounting for 5.51% of the total effect, whereas the indirect effect through job burnout was 0.091, accounting for 31.38% of the total effect. Stress affected turnover intention through the serial mediation of psychological capital and job burnout (indirect effect = 0.041, 14.14% of the total effect). Well-being significantly moderated the association between psychological capital and job burnout, with an index of moderated mediation of -0.0008. The serial indirect effect decreased as well-being increased.

conclusionPsychological capital and job burnout represent important mechanisms linking stress to nurses' turnover intention, and well-being moderates the pathway between psychological capital and job burnout. These findings provide evidence for multidimensional interventions to reduce nurses' turnover intention, including strengthening psychological capital assessment, improving occupational well-being, and optimizing workplace support systems. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse administrators should adopt comprehensive strategies addressing stress, psychological capital, well-being, and job burnout to lower nurses' turnover intention and maintain workforce stability.

Indexed as

Burnout, ProfessionalNursesPersonnel TurnoverStress, PsychologicalAdultChinaCross-Sectional StudiesEast Asian PeopleFemaleHumansIntentionJob SatisfactionMaleMiddle AgedPsychological Well-BeingPsychometricsburnoutnursespsychological capitalstressturnover intentionwell-being

Identifiers

PMID42377279
PMCPMC13317459

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.