A study on the relationship between work stress and turnover intentions among critical care nurses: mediating roles of job satisfaction and burnout

Background Nursing staff shortages and the loss of nursing talent resources remain persistent global challenges. Work stress, job satisfaction, and occupational burnout are key factors influencing nursing staff turnover intentions. Examining the interrelationships among these four variables can provide deeper insights into turnover issues among critical care nurses. Objective To examine the relationship between work stress and turnover intention among nurses in intensive care units. Additionally, this study aims to explore the mediating roles of occupational burnout and job satisfaction, thereby investigating the underlying mechanisms linking work stress, job satisfaction, occupational burnout, and turnover intention within the nursing population. Method A cross-sectional survey was conducted among 257 intensive care unit nurses. Study variables included job stress, job satisfaction, occupational burnout, and turnover intention. Key data underwent bivariate Spearman correlation analysis and mediation analysis using SPSS 27.0 and R 4.4.2. Results Job stress was negatively correlated with job satisfaction ( r = −0.704, p < 0.01) and positively correlated with burnout ( r = 0.616, p < 0.01) and turnover intention ( r = 0.758, p < 0.01). Job satisfaction significantly negatively influenced turnover intention ( r = −0.742, p < 0.01), while occupational burnout significantly positively influenced turnover intention ( r = 0.663, p < 0.01). The structural equation model demonstrated good fit ( χ 2 / df = 2.55; CFI = 0.93, TLI = 0.92; RMSEA = 0.077). Job stress significantly and directly influenced turnover intention ( β = 0.23, p = 0.003), while job satisfaction ( β = 0.098, 95% CI: 0.046–0.153) and occupational burnout ( β = 0.083, 95% CI: 0.045–0.132) concurrently mediated the relationship between job stress and turnover intention. In the overall effect of work pressure on turnover intention, indirect effects (through job satisfaction and burnout) collectively account for 56.56%, while direct effects account for 43.44%. Conclusion This study examined the relationship between job stress and turnover intention, as well as the direct and indirect effects of enhancing job satisfaction and reducing occupational burnout on lowering nurses’ turnover intention. It provides theoretical foundations and practical implications for mitigating nurse turnover issues.