The role of trust and happiness in the relationship between organizational ostracism and turnover intentions among healthcare professionals: a serial mediation model

BACKGROUND: Organizational ostracism is an important yet often overlooked factor affecting healthcare professionals’ well-being and retention. Guided by Social Exchange Theory and Affective Events Theory, this study examines how negative workplace interactions, such as ostracism, trigger interconnected cognitive (organizational trust) and affective (happiness at work) processes that shape turnover intention. The research focuses on understanding the link between organizational ostracism and turnover intention, emphasizing the sequential mediating roles of organizational trust (cognitive) and happiness at work (affective). METHODS: This cross-sectional study surveyed 403 healthcare professionals working in four large public hospitals in Türkiye, recruited through convenience sampling. Data were collected online using SurveyMonkey and analyzed with SPSS version 23 and AMOS version 23. Descriptive statistics, confirmatory factor analysis (CFA), and path analysis were performed, and mediation effects were tested using bias-corrected bootstrapping with 5,000 resamples and 95% confidence intervals (CIs). RESULTS: Organizational ostracism was positively associated with turnover intention. When organizational trust and happiness at work were added as mediators, the direct link between organizational ostracism and turnover intention became non-significant, indicating a full mediation model. Organizational ostracism negatively influenced organizational trust and happiness at work, and both variables played significant roles in explaining turnover intention. Consistent with the cognitive-affective framework, sequential mediation analysis showed that reduced organizational trust contributed to lower happiness at work, further amplifying turnover intention. CONCLUSIONS: Organizational trust and happiness at work are critical mechanisms linking organizational ostracism to turnover intention. Addressing ostracism and fostering supportive, trust-based work environments can help reduce turnover risk and strengthen healthcare teams. These findings provide actionable guidance for healthcare leaders and emphasize the importance of addressing workplace exclusion to enhance workforce stability and team effectiveness.