Co esponding au ho : Salman Salem Alzah ani
Copy igh © 2025 Au ho (s) e ain he copy igh o his a icle. This a icle is published unde he e ms o he C ea i e Commons A ibu ion Liscense 4.0.
Associa ion be ween wo k- ela ed s ess and u no e in en ion among nu ses: A
sys ema ic e iew
Salman Salem Alzah ani 1, *, Dhaki Abbas Ali 2 and Fa idah Mohd Said 1
1 Depa men o Nu sing, Facul y o nu sing and applied science, Lincoln Uni e si y College, Malaysia.
2 Depa men o pos g adua e s udies, acul y o managemen , Lincoln Uni e si y College, Malaysia.
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 27(02), 972-981
Publica ion his o y: Recei ed on 05 July 2025; e ised on 10 Augus ; accep ed on 13 Augus 2025
A icle DOI: h ps://doi.o g/10.30574/wja .2025.27.2.2933
Abs ac
S ess a wo k and nu ses' in en ions o lea e a e impo an ac o s. S ess a wo k can lead o illness and e en acciden s.
S ess a wo k can nega i ely a ec a pe son's heal h and quali y o li e, and nu sing is pe cei ed as challenging. The
s udy aimed o de e mine whe he wo k- ela ed s ess and nu ses' in en ions o lea e hei jobs we e associa ed. The
s udy's design was based on syn hesizing high-quali y publica ions and sys ema ic e iews. Pape s we e iden i ied om
h ee da abases and sea ched in English om 2015 o 2025. S udies selec ed o he s udy me he eligibili y c i e ia
comp ising a icles ha desc ibed wo k- ela ed s ess, bu nou , emo ional dis ess, and occupa ional s ess and a icles
ha e alua ed u no e in en ion, Lack o job ul illmen o ac o s impac ing nu se a i ion. Se e al opics eme ged
ollowing a hema ic analysis. Among he opics co e ed we e he main easons nu ses expe ience s ess a wo k, how
his in luences hei desi e o lea e, me hods o lowe ing s ess a wo k, and nu ses' plans o lea e. The p ima y causes
o wo k- ela ed s ess among nu ses we e wo kload, p olonged shi s, s ained ela ionships wi h cowo ke s, a lack o
p o essional skills, and inadequa e p epa a ion and suppo o handle he men al heal h equi emen s o pa ien s and
hei amilies. I was also no ed ha wo k- ela ed s ess dec eased wo k esilience, bu nou and emo ional dis ess,
esul ing in u no e in en ions among nu ses. S a egies o mi iga e wo k- ela ed s ess include mi iga ing wo kload,
p o iding psychological counseling o nu ses, and a ailing s ess managemen aining o less expe ienced nu ses.
Acco ding o he s udy, wo k- ela ed s ess was linked o nu ses' in en ions o qui , and essen ial s eps mus be aken
o educe nu ses' in en ions o qui . To help hem deal wi h obs acles in he wo kplace mo e e ec i ely, i is necessa y
o ain hei employees—p ima ily nu ses—in coping mechanisms and s ess managemen echniques.
Keywo ds: Wo k- ela ed s ess; Tu no e In en ion; Coping mechanisms; S ess Managemen echniques
1. In oduc ion
Nu sing is seen as a challenging ca ee , and s ess a wo k can ha m a pe son's heal h and quali y o li e. S ess a wo k
can nega i ely impac a pe son's physical and emo ional well-being and p oduc i i y, which in u n can lead o highe
s ess le els. Babapou e al. (2022) illus a e ha nu sing is a s ess ul job linked wi h mul iple job demands and needs,
excessi e esponsibili y, inc eased expec a ions, and minimal au ho i y, which ha e been ecognized as he key
s esso s. S ess a wo k may a ec nu ses' quali y o li e and, in u n, he quali y o ca e hey p o ide. Because hey can
deli e mo e adequa e se ices when hey ha e a highe quali y o li e, nu ses who wo k wi h pa ien s need o lead
high-quali y li es. Va ious easons may esul in u no e in en ion, including dissa is ac ion, ca ee g ow h
oppo uni ies, wo k o e load, sala y issues, and pe sonal ac o s (Huang e al., 2025). Mo eo e , i is linked o a ious
cogni i e, beha io al, and psychological ac o s. Among p o essionals, he u no e a e o nu ses is no ed o be he
highes . Volun a y u no e nega i ely impac s pa ien s and heal hca e o ganiza ions (Zhou e al., 2021). Volun a y
u no e among nu ses has nega i e impac s, which may be di ec o indi ec o heal hca e acili ies. Acco ding o
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Chegini e al. (2019), wo k- ela ed s ess and quali y o li e a e linked wi h u no e in en ion among nu ses wo king
in heal hca e acili ies. Acco ding o Ma e al. (2022), he e is a g ea e need o nu ses in heal hca e acili ies wo ldwide.
Howe e , nu ses a e sca ce and ha e a highe p opensi y o lea e.
Acco ding o Ze anya Sibuea e al. (2024), job ul illmen , dec eased quali y o wo k li e, lack o commi men wi hin an
o ganiza ion, job s ess, leng hened shi s, con lic s wi hin he wo k- amily, bu nou , and o ganiza ional cul u e ha e
been ecognized as ac o s ha could lead nu ses o esign om hei place o Wo k. Fu he mo e, socio-demog aphic
elemen s comp ising ma i al s a us, educa ion, age, and enu e may a ec nu ses' u no e (Snyde , 2019). Wo k-
ela ed s ess is an essen ial ac o a ec ing employee job ul illmen and o ganiza ional commi men , which a e c ucial
p edic o s o u no e . Occupa ional s ess occu s when he e is an imbalance be ween wo ke s' abili y o cope and he
wo kplace demands.
Dealing wi h challenging pa ien s, long wo k hou s, demanding wo king en i onmen s, and a ious occupa ional heal h
and sa e y isks make he heal hca e indus y in insically s ess ul. In heal hca e acili ies, nu ses a e key o deli e ing
ca e and managing pa ien s wi hin heal hca e se ices (Alshamma i & Ali, 2024). Acco ding o Galanis e al. (2024), he
main ac o s in luencing nu ses' in en ion o lea e hei jobs include hei wo king en i onmen , pa icula ly he
a ailabili y o su icien esou ces, nu sing s a ing, wo k- ela ed s ess, ongoing in e ac ion wi h pa ien s and hei
amilies, and dep ession.
Addi ionally, o ganiza ional suppo is an essen ial ac o impac ing u no e in en ion wi hin a demanding and
challenging wo k su ounding heal hca e deli e y. Acco ding o he concep o pe cei ed o ganiza ional suppo ,
employees eel ha hei wo kplace alues p omo e he ca e and well-being o hei cowo ke s (Ran e al., 2024).
Posi i e wo k en i onmen s, manage ial incen i es, help employee’s comple e asks e ec i ely and handle di icul
si ua ions, and senio o supe iso suppo a e all conside ed o ms o o ganiza ional suppo (Wube ie e al., 2020).
Regula ly, nu ses a e con on ed wi h acu e s esso s o c i ical inciden s. Nu ses a e esponsible o ou comes o
pa ien s, mul iplexi y o disease managemen , unce ain y ega ding managemen o pa ien s, p og ession o diseases
om pa ien s, and dealing wi h dying and dea h ha e been ecognized as sou ces o occupa ional s ess among nu ses.
Nu ses ha e men ioned ha inc eased job demands, Lack o s a , e a ic shi wo k, and employee disag eemen s we e
highligh ed as s esso s.
Because nu ses ha e addi ional esponsibili ies and a e o e wo ked, wo k- ela ed s ess can a ec hei compassiona e
conduc . Al hough wo k- ela ed s ess is associa ed wi h lowe quali y o ca e, i also leads o a lack o o loss o
compassion o pa ien s and a ise in p ac ice e o s (Babapou e al., 2022). Nume ous s udies ha e documen ed wo k-
ela ed s ess's di ec o indi ec e ec s on pa ien ou comes and ca e deli e y.
The ela ionship be ween wo k- ela ed s ess and he in en ion o lea e heal hca e p o essionals—p ima ily nu ses—
is assessed in his a icle. The s udy will iden i y p ima y s esso s in nu sing p ac ice and hei impac on nu ses'
in en ions o qui o lea e hei posi ions. De eloping a success ul ac ion plan o educe s ess, encou age job
sa is ac ion, and imp o e nu se e en ion a es equi es acknowledging he connec ion. The e is a sho age o nu ses
wo ldwide; he e o e, acknowledging he ac o s ha esul in nu se u no e is c i ical o heal hca e egula o s and
adminis a o s. High u no e in en ion a es a ec he con inui y and quali y o pa ien ca e while aising he cos s o
hi ing and aining new employees. The s udy also aims o ecognize p ima y s esso s and hei e ec on u no e
in en ion. The s udy aims o p o ide ecommenda ions o in o m ac ion plans wi hin a wo king en i onmen , policy
al e a ions, and suppo sys ems o enhance nu ses' job ul illmen and e en ion.
Objec i es o he S udy
• Gene al Objec i e
o To iden i y he associa ion be ween wo k- ela ed s ess and u no e in en ion among nu ses.
• Speci ic Objec i es
o To ecognize he main causes o nu ses' wo k- ela ed s ess.
o To assess how wo k- ela ed s ess a ec s nu ses' inclina ions o lea e.
o To analyze me hods o lowe ing s ess a wo k and nu ses' in en ions o lea e.
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2. Me hodology
2.1. Da a Sou ces and Sea ch S a egy
A comp ehensi e in o ma ion sea ch was conduc ed using se e al da abases, including PubMed, Science Di ec , and
Google Schola , wi h a pa icula emphasis on English pa icles published be ween 2015 and 2025. A manual sea ch was
also done o ecognize addi ional a icles ha me he eligibili y c i e ia. The sea ch e ms comp ised “wo k- ela ed s ess
OR “Bu nou ” OR “Occupa ional s ess” AND “Tu no e In en ion” OR “Nu se u no e .” Addi ional sea ch e ms
comp ised o “Wo kplace s ess” OR “Job s ess” AND “Nu se Re en ion.” Zo e o 6.0.4 was u ilized o sc een and main ain
he eco ds, e adica ing duplica es. The P e e ed Repo ing I ems o Sys emic Re iews and Me a-Analysis (PRISMA)
we e ca e ully ollowed in o ganizing he sys emic e iew and heme syn hesis.
Table 1 Sea ch Te ms/Keywo ds
Sea ch e ms/ Keywo ds
“Wo k- ela ed s ess OR “Bu nou ” OR “Occupa ional s ess”
AND
“Tu no e In en ion” OR “Nu se u no e .”
OR
“Wo kplace s ess” OR “Job s ess”
AND
“Nu se Re en ion”
In collabo a ion wi h colleagues, he esea che coope a ed wi h colleagues o ensu e he de elopmen o a sea ch s a egy.
The colleagues we e nu ses who we e ully awa e o he opic and had mo e han wo yea s o expe ience in he ield. They
we e well- e sed wi h he e iew objec i es, esponsibili ies, and an icipa ed con ibu ions. The lib a ian was con ac ed
o ensu e ho ough co e age o he keywo ds linked o nu ses' in en ions o lea e hei jobs and wo k- ela ed s ess,
and pa icula sea ch il e s we e applied. I was wo h no ing ha he collabo a i e e o p o ed aluable in na iga ing
he mul iplexi y o sea ching he da a.
S udies ha sa is ied he eligibili y equi emen s examined he ela ionship be ween nu ses' in en ions o lea e hei
jobs and s ess a wo k. They also concen a ed on quali a i e and quan i a i e da a collec ion and analysis echniques.
S udies ha we e eligible comp ised a a ie y o ac o s con ibu ing o wo k- ela ed s esso s, such as job ul illmen ,
o ganiza ional cul u e, and suppo mechanisms. Fu he mo e, he e alua ion was expanded o include s udies ha
assessed how hese cha ac e is ics a ec ed wo k- ela ed s ess and u no e in en ion ou comes in nu sing se ings.
2.2. Selec ion P ocess
Basic e iew ques ions a e key be o e he beginning o any esea ch because hey assis in na owing down he ocus
and concen a ing and iden i ica ion o ele an li e a u e by u ilizing keywo ds and concep s. The PICO (Popula ion,
In e en ion, Con ex , Ou come) app oach was u ilized o cla i y he e iewed opic.
Popula ion: Nu ses comp ising ela ed egis e ed nu ses nu se p ac i ione s wo king wi hin heal hca e se ings.
In e en ion o exposu e: Wo k ela ed s ess comp ising job bu nou , occupa ional s ess, and emo ional exhaus ion.
Compa ison: Nu ses expe iencing li le o no wo k- ela ed s ess o hose wi h wo kplace suppo o manage s ess.
Ou come: Tu no e in en ion, nu se e en ion, o inc eased p obabili y o esigning o lea ing he p o ession. Acco ding
o E iksen & F andsen (2019), he PICOT model is egula ly used o o ganize clinical esea ch opics du ing da a
syn hesis. To gua an ee ha signi ican elemen s o he e iew ques ions a e exp essed, he Coch ane Handbook o
Sys emic Re iews o In e en ion sugges s he u iliza ion o PICOT as a model. I may be modi ied o es ablish a esea ch
ques ion on diagnosis o p ognosis, and he PICOT guidelines a e mo e unde s ood o managemen issues and less
app op ia e o o he clinical da a demands (E iksen & F andsen, 2019). Me hley e al. (2014) illus a ed ha PICOT
was mo e sensi i e and alid o comp ehensi e sea ches han o he me hods such as SPIDER (Sample, Phenom o
In e es , Design, E alua ion, Resea ch).
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Table 2 PICOT
PICOT
Keywo ds
Popula ion
Nu ses comp ise egis e ed nu ses, and nu se p ac i ione s wo king wi hin heal hca e se ings.
In e en ions
Wo k- ela ed s ess comp ises job bu nou , occupa ional s ess, and emo ional exhaus ion.
Compa ison
Nu ses expe iencing li le o no wo k- s ess o hose wi h wo kplace suppo o manage s ess.
Ou come
Tu no e in en ion, nu se e en ion, o inc eased p obabili y o esigning o lea ing he p o ession.
The s udies ha ailed o mee he eligibili y c i e ia comp ised o a) s udies ha highligh pe sonal s ess wi hou clea
associa ion wi h Wo k, b) A icles discussing nu se u no e wi hou e alua ing he ole o wo k- ela ed s ess, c) non-
empi ical s udies such as abs ac s, unpublished disse a ion/ heses, and d) a icles w i en in o he languages o he han
English. Colleagues examined he abs ac and i le o he a icle. Sc eening o ull- ex s on eligible publica ions was
e iewed by a single esea che who hen add essed any doub s wi h he colleagues.
Table 3 Eligibili y C i e ia
Inclusion C i e ia
Exclusion C i e ia
A icles ocusing on all nu sing cad es wi hin heal hca e
se ings.
S udies ha highligh pe sonal s ess wi hou clea
associa ion wi h Wo k.
A icles ha e alua ed wo k- ela ed s ess, bu nou ,
emo ional dis ess, and occupa ional s ess.
A icles discussing nu se u no e wi hou
e alua ing he ole o wo k- ela ed s ess.
A icles e alua ing u no e in en ion, Lack o job ul illmen ,
o ac o s impac ing nu se a i ion.
Non-empi ical s udies such as abs ac s, and
unpublished disse a ions/ heses.
Pee - e iewed quali a i e, quan i a i e, o mixed me hods
a icles.
S udies published in o he languages o he han
English.
A icles published in English wi hin he las 20 yea s.
Da a collec ed wo ldwide wi hin heal hca e se ings, hospi al
se ings o heal hca e su oundings. Back
2.3. Da a Ex ac ion
The ollowing in o ma ion was included in each s udy: he au ho o au ho s, he yea o publica ion, he ela ionship
be ween nu ses' in en ions o lea e hei jobs and wo k- ela ed s ess, and me hods o educing he ela ionship
be ween hese wo a iables.
2.4. Syn hesis o Findings
Th ee s eps we e inco po a ed in o he hema ic syn hesis. The i s s ep comp ised o he esea che coding ele an
con en line by line. Acco dingly, desc ip i e hemes ac oss s udies we e de eloped by o ganizing he ee codes. A
coding manual was es ablished o gua an ee a sys emic echnique o coding he in o ma ion. A e an ex ensi e
examina ion o he opics ecognized, any disag eemen s we e esol ed un il an ag eemen was a ained. The hi d
phase was “going beyond” he da a o ecognize analy ical hemes ha p o ide esh opinions when pai ed wi h he i s
esea ch. The esea che c ea ed a model o illus a e how he hemes ela e o he ecogni ion o ac o s and coping
s a egies ela ed o job ul illmen among nu ses a e u ilizing g oup b ains o ming o o e a ching hemes o
elabo a e he ela ionship be ween wo k- ela ed s ess and nu se u no e in en ion among nu ses.
2.5. Risk o Bias and Quali y Assessmen
The esea che conduc ed an exhaus i e li e a u e sea ch ac oss mul iple key da abases, employing a well-de ined
sea ch s a egy ha in eg a ed a ious keywo ds and Boolean ope a o s. This sea ch was es ic ed o a icles
published in con e ence p oceedings and pee - e iewed jou nals o dec ease he likelihood o selec ion bias. A
echnique om he C i ical App aisal Skills P og am was used o e alua e he a icles' bene i s and d awbacks.
Rega dless o he quali y, all documen s we e included in he e iew. Each documen was examined by colleagues, while
engaging in discussions o so ou any issues ega ding he quali y e alua ion. The e iew p o ides an ex ensi e and
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976
s aigh o wa d accoun o da a sou ces, sea ch s a egy, s udy selec ion p ocess, and syn hesis o esul s. The esul s
a e enhanced by using ables o summa ize p ima y da a e ec i ely.
3. Resul s
3.1. Sys ema ic Li e a u e Sea ch
The igu e below highligh s he PRISM 2020 low diag am. As o 2025, 360 i ems ha may be o in e es we e e ie ed
om mul iple elec onic da abases. O hese, 180 we e ound in Science Di ec , 80 in PubMed, and 100 in Google Schola .
The w i e s’ absolu e dependence on well-es ablished da abases is enume a ed by he ac ha hey did no acqui e
pape s om o he sou ces. They enhanced he in eg i y o hei e iew p ocess by educing he quan i y o 200 unique
a icles a e elimina ing 160 duplica es.
Du ing he sc eening s age 210 a icles we e elimina ed due o a ious easons such as i ele ance, Lack o da a, and
e iew a icles. Ex ensi e sc eening o da a illus a ed dedica ion o upholding s ic eligibili y c i e ia. A e wa d,
abs ac s we e quickly il e ed, b inging i down o 190 a icles. Subsequen ly, eading he comple e ex s ollowed,
which u he elimina ed pape s ha lacked adequa e da a o we e ound o be modeling s udies. In he inal analysis,
he esea che ’s e iew highligh ed eigh publica ions, enume a ing a a ge ed and selec i e me hod ha ga e high-
quali y da a o e quan i y. Thanks o he ex ensi e sc eening o he li e a u e, he sys emic e iew aligned wi h he
objec i es o he sys emic e iew, which enhanced he eliabili y and alidi y o he s udy.
Figu e 1 Selec ion C i e ia
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3.2. S udy Cha ac e is ics
Acco ding o he syn hesis o s udies illus a ed in he able below, he s udies included in his e iew e alua ed a ious
subjec s linked o nu se p oblems due o Wo k- ela ed s esso s. The main a ea o s udy was he ecogni ion o
occupa ional s esso s and i s associa ion o nu se u no e . The p ima y goal o he s udy was o iden i y he p ima y
ways ha wo k- ela ed s esso s may lead o nu se u no e and o examine he ela ionship be ween wo k- ela ed
s esso s and nu ses' in en ions o lea e hei jobs.
In se e al heal hca e ins i u ions, he s udy assessed a ious aspec s o wo k- ela ed s esso s, including dep ession,
anxie y, and bu nou . One o he mos impo an poin s men ioned in he li e a u e was how o ganiza ional suppo
migh help heal hca e se ings deal wi h wo k- ela ed p essu es. The in es iga ions, which we e ca ied ou in a a ie y
o con ex s, ga e a ho ough pic u e o he cu en landscape ega ding he ela ionship be ween nu ses' in en ion o
lea e and s esso s associa ed o hei jobs. The esul s illus a ed a mul iplex na u e o wo k- ela ed s ess and nu se
u no e in en ion. They o e emphasized he need o a ge ed in e en ions o os e wellness and esilience among
nu se p ac i ione s.
Table 4 Selec ed A icles
Re e ences
Objec i e
Resea ch
Me hods
Resul s
Themes
AL-Yaqoubi and
A ulappan
(2024)
The s udy aimed o
es ablish he sou ces o
wo k- ela ed s ess
among Omani nu ses.
Desc ip i e
c oss-
sec ional
design
A nu sing s essing scale was
u ilized and es ablished ha
wo kload esul ed in he highes
le el o wo k- ela ed s ess. I was
ollowed by emo ional conce ns
associa ed wi h dea h and dying.
Lack o suppo and adequa e
p epa a ion o mee he emo ional
needs o pa ien s and hei amilies.
Key sou ces o
wo k- ela ed
s ess among
nu ses.
Elshaday Bekele
We ke and
Zewdu
Shewangizaw
We e (2023)
The s udy aimed o
de e mine occupa ional
s ess and associa ed
ac o s among nu ses
wo king a public
hospi als in Addis
Ababa, E hiopia, in 2022.
C oss-
sec ional
s udy design
Key sou ces o wo k- ela ed s ess
include wo king long shi s.
Key sou ces o
wo k- ela ed
s ess among
nu ses.
Liu e al. (2023)
The s udy aimed o
e alua e nu ses'
u no e in en ion in
China and assess he
associa ed ac o s.
C oss-
sec ional
s udy design
The s udy illus a ed ha mos
nu ses had a high p e alence o
u no e in en ion a 69.4%. The
s udy illus a es ha being a junio
nu se and below, a clinical nu se,
le el o pay, ele a ed job sa is ac ion
ha ing a high sense o belonging,
and con lic s wi h colleagues
impac ed u no e in en ion among
nu ses.
E ec o wo k-
ela ed S ess
on Nu ses'
u no e
in en ions
Shah e al.
(2022)
The s udy's objec i e
was o ecognize he
associa ion be ween job
s ess s a e ange ,
emo ional dis ess, and
job u no e in en ion.
C oss-
sec ional
s udy design
The s udy illus a ed ha wo k-
ela ed s ess esul ed in dec eased
wo k esilience esul ing in
u no e in en ion.
Impac o
wo k- ela ed
s ess on
u no e
in en ion.
Tsegaw e al.
(2022)
The s udy was aimed a
enume a ing he
de e minan s o wo k-
ela ed s ess among
C oss-
sec ional
s udy design
Acco ding o he s udy, he ype o
ins i u ion was a de e minan o
wo k- ela ed s ess. As a esul ,
compa ed o nu ses who wo ked in
Key sou ces o
wo k- ela ed
s ess among
nu ses.
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978
nu ses wo king in
p i a e and public.
p i a e hospi als, hose who wo ked
in public hospi als had highe s ess
le els. The s udy concluded ha
mi iga ing wo kload, p o iding
psychological counseling o nu ses,
and a ailing s ess managemen
aining o less expe ienced nu ses
was ound o educe Wo k- ela ed
s ess.
S a egies o
educe wo k-
ela ed s ess
and mi iga e
u no e
in en ion
among nu ses.
Wang e al.
(2022)
The s udy’s objec i e
was o e alua e he
associa ion be ween
coping s a egies,
s esso s, and in en ion
o lea e he nu sing
p o ession among
nu ses.
C oss-
sec ional
s udy design
Acco ding o he s udy, occupa ional
inju ies, high job demands, nu se-
pa ien ension, s ic leade s, and
poo colleague ela ionships had a
highe signi ican in en ion o lea e.
Key sou ces o
wo k- ela ed
s ess among
nu ses.
Zhou e al.
(2021)
The s udy aimed o
e alua e he possible job
s ess ac o s ha could
impac newly ec ui ed
nu ses’ beha io o
ei he con inue wi h
jobs o discon inue hei
jobs wi hin an
o ganiza ion.
C oss-
sec ional
s udy design
The s udy illus a ed ha a ious
wo k- ela ed s esso comp ising o
s ess om ellow nu ses, Lack o
p o essional skills, s ess om
looking a e pa ien s, and s ess
om wo kloads and oles played a
key ole in impac ing nu se u no e
in en ion.
Key sou ces o
wo k- ela ed
s ess among
nu ses.
3.3. Syn hesis o Resul s
Following a s udy o he analysis's a icles, he esea che wen in o u he de ail abou he h ee main hemes. Key
sou ces o wo k- ela ed s ess among nu ses, he impac o wo k- ela ed s ess on nu ses' in en ions o lea e hei jobs,
and me hods o educe wo k- ela ed s ess and u no e in en ions among nu ses we e among he subjec s.
3.3.1. Key Sou ces o Wo k- ela ed S ess among Nu ses
Acco ding o Liu e al. (2023), nu ses' in en ions o lea e hei jobs we e in luenced by hei s a us as junio nu ses o less,
clinical nu ses, income, deg ee o job sa is ac ion, sense o belonging, and dispu es wi h hei cowo ke s. Acco ding o Shah
e al. (2022), s ess a wo k educes esilience, leading o a desi e o lea e. Acco ding o Tsegaw e al. (2022), he kind o
ins i u ion was one ac o in luencing wo k- ela ed s ess. Wang e al. (2022) ound ha a signi ican in en ion o lea e
was associa ed wi h occupa ional inju ies, high job expec a ions, nu se-pa ien con lic , s ic leade s, and poo colleague
ela ionships. Las bu no leas , Zhou e al. (2021) showed ha se e al wo k- ela ed s esso s, such as s ess om
cowo ke s, a lack o p o essional skills, s ess om pa ien ca e, and s ess om wo kloads and du ies, signi ican ly
in luenced nu ses' in en ions o lea e hei jobs.
3.3.2. The E ec o Wo k- ela ed S ess on Nu ses' Tu no e In en ions.
Acco ding o Liu e al. (2023), nu ses' in en ions o lea e hei jobs we e in luenced by hei s a us as junio nu ses o less,
clinical nu ses, income, deg ee o job sa is ac ion, sense o belonging, and dispu es wi h hei cowo ke s. Acco ding o Shah
e al. (2022), s ess a wo k educes esilience, leading o a desi e o lea e.
3.3.3. The S a egies o Reduce Wo k- ela ed S ess and Mi iga e Tu no e In en ion Among Nu ses.
Tsegaw e al. (2022) ound ha educing wo kload, o e ing psychological counselling o nu ses, and o e ing s ess
managemen aining o less expe ienced nu ses all help o lessen wo k- ela ed s ess.
4. Discussion
The analysis highligh ed h ee key subjec s in he esea ch abou he ela ionship be ween s ess a wo k and nu ses'
plans o lea e. The subjec s included he p ima y causes o s ess a wo k, how s ess impac s in en ions o lea e, and
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 27(02), 972-981
979
me hods o educing wo k- ela ed s ess and in en ions o lea e as a nu se. This sec ion in eg a es he in o ma ion and
o e s an in-dep h e iew o he issues.
4.1. Key Sou ces o Wo k- ela ed S ess among Nu ses
Acco ding o AL-Yaqoubi and A ulappan (2023), he mos c ucial sou ce o wo k- ela ed s ess among bu ses is
wo kload. Men al and physical exhaus ion occu s due o he inc eased demand, which is illus a ed by cons ained
ime ables and an inc eased numbe o pa ien s. The s ess le els a e inc eased u he by he emo ional dis ess ha
occu s while ca ing o pa ien s who a e c i ically ill in addi ion o dealing wi h dea h. Mo eo e , due o dec eased
suppo ne wo ks and Lack o p epa edness o a end o pa ien s’ emo ional needs, by insu icien suppo ne wo ks.
As ecognized by We ke and We e (2023), long shi s we e iewed as a signi ican wo k- ela ed s esso . Long shi s
esul in a igue, minimized job ul illmen , and minimal pe o mance, all con ibu ing o ele a ed u no e in en ions.
I was es ablished ha job bu nou is a key ac o be ween u no e in en ion and mo al esilience, enume a ing ha
emo ional exhaus ion and ch onic s ess c i ically a ec nu ses’ decision o esign.
O ganiza ional ac o s play a c i ical ole in con ibu ing o wo k- ela ed s ess. Tsegaw e al. (2022) highligh ed ha
heal hca e acili ies impac s ess le els wi h nu ses in ce ain se ings expe iencing inc eased s ess le els due o
limi ed esou ces and wo kload demands. Likewise, Wang e al. (2022) elabo a ed ha inc eased u no e in en ions
we e due o high wo king expec a ions, occupa ional inju ies, s ained nu se-pa ien ela ionships, and poo
associa ions wi h cowo ke s. The indings o Zhou e al. (2021), pa ien ca e obliga ions, p o essional compe ence
sho comings, ole- ela ed p essu es, and s ess om o he nu ses all impac u no e in en ions. The indings
illus a e he mul iplex associa ion be ween o ganiza ional and pe sonal cha ac e is ics and wo k- ela ed s ess in
nu ses.
4.2. The E ec o Wo k- ela ed S ess on Nu ses' Tu no e In en ions
Va ious s udies p o e he ha m ul e ec o wo k- ela ed s ess on nu ses’ in en ions. Acco ding o Liu e al. (2023), i
was es ablished ha junio nu ses, clinical nu ses, and hose wi h low pay le els we e mo e ulne able o u no e
in en ions. Job ul illmen and a sense o belonging we e con e sely linked o u no e in en ions, illus a ing he
signi icance o p omo ing a suppo i e and ul illing wo k su ounding. Fu he mo e, con lic s wi h colleagues u he
con ibu ed o u no e in en ions, illus a ing he esponsibili y o in e pe sonal associa ions in di ec ing nu ses’ job
expe iences.
Shah e al. (2022) also enume a e he associa ion be ween wo k- ela ed s ess and minimized wo k esilience,
con ibu ing o u no e in en ions. Wo k esilience, he abili y o adap o and eco e om s ess, is c ucial o
main aining job ul illmen and pe o mance. Nu ses’ endu ance diminishes and u no e is mo e p obable when hey
endu e ele a ed s ess wi hou app op ia e coping s a egies. When aken as an en i e y, he a icles illus a ed how
s ess a Wo k hinde s esilience, job ul illmen , and a sense o belonging, which in luences a nu se’s u no e
in en ions.
4.3. The S a egies o Reduce Wo k- ela ed S ess and Mi iga e Tu no e In en ion Among Nu ses
Wo k- ela ed s ess mus be esol ed o mi iga e u no e in en ions and e ain a skilled wo k o ce. Acco ding o
Tsegaw e al. (2022), i was es ablished ha he e a e a ious e ec i e s a egies comp ising o a ailing psychological
counseling, educing wo kload, and p o iding s ess managemen educa ion, speci ically o nu ses who ha e li le o
no expe ience. The wo kload can be minimized by maximizing s a le els, edis ibu ion o Wo k, and o e simpli ying
wo k lows o mi iga e he emo ional and physical bu den on nu ses. Execu ing a lexible schedule and gua an eeing
pe iods o es can help educe he impac s o long shi s.
Psychological counseling p o ides a sa e space o nu ses o p ocess emo ional challenges linked wi h pa ien dea h,
ca e, and dying. P o essional suppo assis s nu ses in de eloping coping mechanisms, gua an ees emo ional esilience,
and p o ec s agains bu nou . Fu he mo e, s ess managemen educa ion nu ses wi h p ac ical me hods o manage
s ess o main ain hei wellness. Cus omizing hese in e en ions o he pa icula needs o nu ses wi h less expe ience
is c i ical as hey a e mo e suscep ible o s ess due o limi ed coping s a egies and clinical expe ience.
Es ablishing a suppo i e su ounding is c ucial o mi iga ing wo k- ela ed s ess and u no e in en ions. P omo ing
open communica ion, os e ing eamwo k, and p omo ing a posi i e associa ion among colleagues can p omo e
ul illmen wi hin he wo kspace and es ablish a sense o belonging. P ope leade ship skills a e c ucial in educing
wo k- ela ed s ess by mee ing well-de ined expec a ions, iden i ying nu ses’ con ibu ions, and p o iding cons uc i e
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 27(02), 972-981
980
eedback. Enhancing leade ship skills among nu se manage s can assis in c ea ing empa hy, a cul u e o espec , and
collabo a ion, mi iga ing he s ess linked o s ic o unsuppo i e leade ship.
Addi ionally, sol ing o ganiza ional issues such as ca ee de elopmen , pay, and p o essional g ow h can help minimize
nu ses’ u no e in en ion and assis in he e en ion o highly skilled employees. Compe i i e pay, skills g ow h
oppo uni ies, and p o essional g ow h de elopmen ele a e job ul illmen and mo i a ion. Con inuous educa ion and
aining can assis nu ses in de eloping he p o essional skills equi ed o manage hei oles su icien ly, mi iga ing
s ess, compe ence, and pe o mance.
5. Conclusion
The s udy es ablished om he iden i ied a icles he signi ican e ec o wo k- ela ed s ess on nu ses’ u no e
in en ions. Key sou ces o wo k- ela ed s esso s include leng hened shi s, inc eased wo kload, emo ional s ain, and
o ganiza ional p oblems con ibu ing o emo ional dis ess and dec eased job ul illmen . In addi ion o ha ing a
de imen al impac on nu ses’ pe o mances and wellness, hese s esso s aise he likelihood ha hey will lea e hei
jobs. Sol ing he leading causes o s ess is c ucial o mi iga ing u no e in en ions and e aining skilled heal hca e
p ac i ione s. Execu ing in e en ions comp ising wo kload managemen , psychological counseling, and managemen
o s ess can assis nu ses in es ablishing esilience and de eloping coping mechanisms wi h challenges wi hin he
wo kspace. Likewise, enhancing job ul illmen and dec easing u no e in en ions equi es es ablishing a suppo i e
wo k su ounding, p omo ing heal hy in e pe sonal in e ac ions, and p o iding ca ee g ow h oppo uni ies.
Recommenda ions
F om he s udy, i was ecommended ha :
• Heal hca e acili ies should p o ide lexible schedules, gua an ee app op ia e nu se- o-pa ien a ios, and
edis ibu e Wo k o mi iga e emo ional and physical dis ess.
• Heal hca e acili ies need o suppo hei s a , pa icula ly nu ses, by aining hem on s ess managemen
echniques and coping s a egies o assis hem in na iga ing challenges mo e e icien ly wi hin he wo king
en i onmen .
• Heal hca e se ings can p o ide an en i onmen ha os e s eamwo k and collabo a ion by p omo ing open
communica ion, mu ual suppo , and eamwo k among s a , which enhances job ul illmen , mi iga es s ess,
and p omo es a sense o belonging.
• Wi hin he heal hca e se ings heal hca e p ac i ione s especially nu ses should be ained on empa he ic
leade ship, well-de ined communica ion channels, and eedback o p omo e a posi i e and suppo i e wo king
space.
Compliance wi h e hical s anda ds
Disclosu e o con lic o in e es
No con lic o in e es o be disclosed.
Re e ences
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a media ing ole o wo kplace digni y. In e na ional Jou nal o Religion, 5(3), 386-398.
[2] AL-Yaqoubi, S., & A ulappan, J. (2023). Sou ces o Wo k-Rela ed S ess Among Omani Nu ses: A C oss-Sec ional
S udy. Jou nal o Pa ien Expe ience, 10(237437352311), 237437352311665.
h ps://doi.o g/10.1177/23743735231166504
[3] Babapou , A. R., Gahassab-Moza a i, N., & Fa hnezhad-Kazemi, A. (2022). Nu ses’ job s ess and i s impac on
quali y o li e and ca ing beha io s: a c oss-sec ional s udy. BMC nu sing, 21(1), 75.
[4] Chegini, Z., Asgha i Ja a abadi, M., & Kakemam, E. (2019). Occupa ional s ess, quali y o wo king li e and
u no e in en ion amongs nu ses. Nu sing in C i ical Ca e, 24(5). h ps://doi.o g/10.1111/nicc.12419
