Exploring the Role of Professional Burnout and Mental Health Strain in Nurses' Turnover Intentions: A Mediation Study.

Background: Nurses' turnover intentions had a significant challenge to healthcare systems worldwide. Burnout substantially contributes to turnover intentions and actual departure behavior, yet the underlying mechanisms remain underexplored. Aim: To examine the mediating role of mental health strain in the relationship between professional burnout and nurses' turnover intentions. Methods: This cross-sectional study employed a nonprobability, convenience sample of 234 registered nurses working at two tertiary hospitals in the Damietta Governorate, Egypt. Out of the 255 questionnaires distributed, 234 were returned, yielding a 91.8% response rate. Data were collected using self-reported questionnaires, including the Copenhagen Burnout Inventory (specifically work-related burnout subscale), the General Health Questionnaire, and the Turnover Intentions Scale, in addition to a demographic information form. Data were analyzed using descriptive and inferential statistics followed by Hayes' PROCESS Macro (Model 4) to conduct mediation analysis. Results: Professional burnout had a substantial positive direct influence on mental health strain (B = 0.221, p < 0.001) and turnover intentions (B = 0.589, p < 0.001). Mental health strain also substantially affected turnover intentions (B = 0.749, p < 0.001). Mediation analysis showed that mental health strain partially mediated the association between professional burnout and turnover intentions (B = 0.166; 95% CI [0.090-0.256]). Moreover, age (B = 0.067, p < 0.05) and experience (B = -0.078, p < 0.05) had a statistically significant influence on turnover intentions. Conclusions: The findings highlight mental health strain as a crucial pathway through which professional burnout affects turnover intentions among nurses. Nursing managers should implement strategies to reduce professional burnout and support nurses' mental well-being to enhance retention and workforce stability. Additionally, health policymakers should consider implementing national standards for safe staffing, institutionalized mental health support programs, and long-term investments in workplace wellness to ensure a resilient and sustainable nursing workforce.