Impacts of Job Demands on Turnover Intention Among Registered Nurses in Hong Kong Public Hospitals: Exploring the Mediating Role of Burnout and Moderating Effect of Pay Level Satisfaction

Background: High turnover rates and burnout are prevalent issues among registered nurses in public hospitals in Hong Kong. Pay level satisfaction is one of the crucial factors influencing organisational and professional turnover intention. Understanding whether pay level satisfaction can mitigate the negative impact of burnout on turnover intention can provide insights into the role of financial rewards in employee retention. Objective: This study aims to evaluate the relationship between job demands and turnover intention among registered nurses in Hong Kong public hospitals. Additionally, it seeks to examine the mediating role of burnout and explore the potential moderating effect of pay level satisfaction on the relationship between burnout and turnover intention. Methods: The study was a cross-sectional online survey of public hospital staff in Hong Kong. A total of 502 registered nurses who had worked at their employing facility for at least 6 months participated in this cross-sectional survey. Study variables included work overload, job stress, work-family conflict, family-work conflict, conflict with other nurses, burnout, pay level satisfaction and turnover intention. The collected data were analysed using bivariate Pearson correlation analysis and mediated moderation analysis with the PROCESS macro in SPSS 28.0.Results: Burnout mediated the relationship between job demands, including work overload, job stress, work-family conflict, family-work conflict and conflicts with nurses, and organisational and professional turnover intention. Pay level satisfaction did not exert a moderating influence on the relationship between job demands and turnover intention through burnout mediating this relationship. Conclusions: The importance of addressing job stress and burnout to mitigate turnover intention and promote nurse retention is underscored. Contrary to expectations, pay level satisfaction did not buffer the negative impact of job demands on turnover intentions via burnout. This suggests that compensation alone may not be sufficient to offset the detrimental effects of high job demands and burnout on nurses' intention to leave their jobs or the profession. Further research is warranted to explore potential moderators that may influence the relationship between job demands and turnover intention.