Professional quality of life, sleep quality, occupational stress, and turnover intention among emergency department nurses: A cross-sectional study.

The mean turnover intention score among ED nurses was 49.26.

• Study conducted in 2025 using a descriptive cross-sectional design.
• Sample included 180 nurses working in emergency departments of university hospitals in Tehran Province.
• Turnover intention was measured using the Turnover Intention Questionnaire.
• Data analysis employed descriptive statistics, Spearman rank correlation, Mann-Whitney U and Kruskal-Wallis H tests, and robust regression.

Secondary traumatic stress (STS) showed the strongest correlation with turnover intention among all measured variables.

• STS was correlated with turnover intention at r = 0.594 (p < 0.01).
• This was the highest correlation coefficient among all variables examined.
• STS was measured as a subscale of the Professional Quality of Life Scale (ProQOL).
• STS also emerged as a significant predictor of turnover intention in the regression analysis.

Compassion satisfaction was negatively and significantly correlated with turnover intention.

• The correlation between compassion satisfaction and turnover intention was r = -0.555 (p < 0.01).
• This was the only variable with a negative correlation with turnover intention.
• Compassion satisfaction was a significant predictor of turnover intention in the robust regression analysis.
• Compassion satisfaction is a subscale of the ProQOL scale.

Burnout was significantly and positively correlated with turnover intention.

• The correlation between burnout and turnover intention was r = 0.575 (p < 0.01).
• Burnout was a significant predictor of turnover intention in the regression analysis.
• Burnout is a subscale of the Professional Quality of Life Scale (ProQOL).
• Burnout had the second strongest positive correlation with turnover intention after STS.

Occupational (job) stress was significantly associated with turnover intention.

• The correlation between job stress and turnover intention was r = 0.408 (p < 0.01).
• Job stress was measured using the Expanded Nursing Stress Scale (ENSS).
• Job stress was a significant predictor of turnover intention in the robust regression analysis.

Sleep quality was significantly associated with turnover intention among ED nurses.

• The correlation between sleep quality and turnover intention was r = 0.329 (p < 0.01).
• Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI).
• Sleep quality was examined but its role as an independent predictor in the regression model is not specified as significant in the abstract.
• This positive correlation indicates that poorer sleep quality was associated with higher turnover intention.

Financial status, nurse-to-patient ratio, and shift type were significant predictors of turnover intention in the regression analysis.

• These three work-related and demographic factors were identified as significant predictors alongside ProQOL components and job stress.
• These variables were included in the robust regression model.
• Shift type was identified as a predictor, suggesting that scheduling practices are associated with nurses' intention to leave.
• Nurse-to-patient ratio being a predictor indicates that staffing levels are independently associated with turnover intention.

All ProQOL subscales (compassion satisfaction, burnout, and secondary traumatic stress) were significantly associated with turnover intention.

• Correlations for all three ProQOL subscales were statistically significant at p < 0.01.
• Correlation coefficients were: compassion satisfaction r = -0.555, burnout r = 0.575, STS r = 0.594.
• All three ProQOL components were also retained as significant predictors in the robust regression model.
• ProQOL was measured using the Professional Quality of Life Scale (ProQOL).