Occupational stress, distributive justice and turnover intention among public hospital nurses in China: A cross-sectional study

Aim: To examine the mediating role of distributive justice on the relation between occupational stress and turnover intention, and the regional role in moderating the relationship between distributive justice and turnover intention. Background: Turnover intention is an effective indicator of job departure and has been widely studied. Identification of methods to reduce turnover intention among nurses is a focus of the new round of medical and health system reform in China and in the realization of the “Healthy China 2030” policy. However, few studies have examined the present situation of Chinese nurse's turnover intention and corresponding influencing factors. Methods: Data were collected on-site by using questionnaires designed by anonymous researchers. A total of 718 effective questionnaires were allocated from representative public hospitals. Data were collected for the “Challenge and Hindrance-Related Self–Reported Stress Scale”, “Distributive Justice Scale” and “Turnover Intention Scale”. Results: Challenge stress was significantly inversely correlated with turnover intention, while hindrance stress was significantly positively correlated with turnover intention. Moreover, there was a significant inverse correlation between the two types of occupational stress and distributive justice and an inverse correlation between distributive justice and turnover intention. Regional role had a moderating effect on the correlation between distributive justice and turnover intention. Conclusions: Chinese nurses' turnover intention is directly or indirectly influenced by occupational stress and distributive justice. Managers should set reasonable goals to cope with challenging stress. Proper intervention measures should be designed such as reducing barrier pressure, increasing remuneration, and promoting the matching between workload and job value to reduce the turnover intention. Finally, balancing the treatment towards nurses in different regions may help achieve relative fairness.