Factors Affecting Turnover Intention In Public Healthcare Workforce: A Conceptual Study



A high turnover rate is a critical challenge to any organisation, especially in the healthcare sector, considering the involvement of high costs, significant efforts to develop human capital, and other negative implications. Focusing on the identification of factors that affect turnover in the public healthcare workforce, specifically among medical doctors in public hospitals, a conceptual model was proposed in this paper based on the review of key literature on the relationships of cross-behavioural factors for the assessment of employees’ turnover intention. This conceptual paper extends the body of knowledge on the significant effects of work-family conflict, role stressors, and employee engagement on turnover intention.


Ahmad, A., & Afgan, S. (2016). The Relationship of Job Stress and Turnover Intention in Commercial Banks of Pakistan by Assessing the Mediating Role of Burnout. Journal of Business Strategies, 10(1), 1–23.
Albaqami, A. (2016). Determinants of turnover intention among faculty members in Saudi public universities. ProQuest Dissertations and Theses. University of Salford.
Albrecht, S. L., & Marty, A. (2017). Personality, self-efficacy and job resources and their associations with employee engagement, affective commitment and turnover intentions. International Journal of Human Resource Management, 5192, 1–25.
Alhamwan, M., Mat, N. B., & Muala, I. Al. (2015). The Impact of Organizational Factors on Nurses Turnover Intention Behavior at Public Hospitals in Jordan: How Does Leadership, Career Advancement and Pay-Level Influence the Turnover Intention Behavior among Nurses. Journal of Management and Sustainability, 5(2).
Asghar, M., Gull, N., Bashir, M., & Akbar, M. (2018). The Impact of Work-Family Conflict on Turnover Intentions: The Moderating Role of Perceived Family Supportive Supervisor Behavior. Journal of Hotel and Business Management, 07(01), 1–11.
Bedeian, A. G., & Armenakis, A. A. (1981). A path-analytic study of the consequences of role conflict and ambiguity. Academy of Management Journal. Academy of Management, 24(2), 417–424.
Blau, G. J., & Boal, K. B. (2011). Conceptualizing How Job Involvement and Organizational Commitment Affect Turnover and Absenteeism. Academy of Management Review, 12(2), 288–300.
Blomme, R. J., Van Rheede, A., & Tromp, D. M. (2010). Work-Family Conflict as a Cause for Turnover Intentions in the Hospitality Industry. Tourism and Hospitality Research, 10(4), 269–285.
Bluedorn, A. C. (1982). A Unified Model of Turnover from Organizations. Human Relations, 35(2), 135–153.
Bonds, A. A., & Bonds, A. A. (2017). Employees ’ organizational commitment and turnover intentions. ProQuest Dissertations and Theses. Walden University.
Bothma, C. F. C., & Roodt, G. (2013). The validation of the turnover intention scale. SA Journal of Human Resource Management, 11(1), 1–12.
Bright, J. B. (2018). The relationship between transformational leadership behaviors and employee engagement and turnover intent. ProQuest Dissertations and Theses. Walden University.
Chao, M. C., Jou, R. C., Liao, C. C., & Kuo, C. W. (2015). Workplace stress, job satisfaction, job performance, and turnover intention of health care workers in rural Taiwan. Asia-Pacific Journal of Public Health, 27(2), NP1827–NP1836.
Chen, H., Ayoun, B., & Eyoun, K. (2018). Work-Family conflict and turnover intentions: A study comparing China and U.S. hotel employees. Journal of Human Resources in Hospitality and Tourism, 17(2), 247–269.
Choi, S. L., Goh, C. F., Adam, M. B. H., & Tan, O. K. (2016). Transformational leadership, empowerment, and job satisfaction: the mediating role of employee empowerment. Human Resources for Health, 14(1), 73.
Cohen, G., Blake, R. S., & Goodman, D. (2016). Does Turnover Intention Matter? Evaluating the Usefulness of Turnover Intention Rate as a Predictor of Actual Turnover Rate. Review of Public Personnel Administration, 36(3), 240–263.
Collini, S. A., Guidroz, A. M., & Perez, L. M. (2015). Turnover in health care: The mediating effects of employee engagement. Journal of Nursing Management, 23(2), 169–178.

Cotton, J. L., & Tuttle, J. M. (1986). Employee Turnover: A Meta-Analysis and Review with Implications for Research. Academy of Management Review, 11(1), 55–70.
Curran, T. M., & Prottas, D. J. (2017). Role stressors, engagement and work behaviours: a study of higher education professional staff. Journal of Higher Education Policy and Management, 39(6), 642–657.
Dåderman, A. M., & Basinska, B. A. (2016). Job demands, engagement, and turnover intentions in Polish nurses: The role of work-family interface. Frontiers in Psychology.
Devi, K. R., & Rani, S. S. (2016). The Impact of Organizational Role Stress and Work Family Conflict: Diagnosis Sources of Difficulty at Work Place and Job Satisfaction among Women in IT Sector, Chennai, Tamil Nadu. Procedia - Social and Behavioral Sciences, 219, 214–220.
Eastham, R. S. (2014). Role stressors and intent to leave: A study of hotel general managers. ProQuest Dissertations and Theses. University of Oklohama.
Gilmartin, M. J. (2012). Thirty years of nursing turnover research: looking back to move forward. Medical Care Research and Review, 1–26.
Greenhaus, J. H., & Beutell, N. J. (2011). Sources of Conflict Between Work and Family Roles. Academy of Management Review, 10(1), 76–88.
Greyling, J., & Stanz, K. (2010). Turnover of nursing employees in a Gauteng hospital group. SA Journal of Industrial Psychology, 36(1), 1–11.
Hafiz, A., Ima-Nirwana, S., & Chin, K. Y. (2018). Comparison of stress levels between physicians working in public and private hospitals in Johor, Malaysia. Journal of Taibah University Medical Sciences, 13(5), 491–495.
Hatam, N., Jalali, M. T., Askarian, M., & Kharazmi, E. (2016). Relationship between Family-Work and Work-Family Conflict with Organizational Commitment and Desertion Intention among Nurses and Paramedical Staff at Hospitals. International Journal of Community Based Nursing and Midwifery, 4(2), 107–118.
Holtom, B. C., Mitchell, T. R., Lee, T. W., & Eberly, M. B. (2008). Turnover and Retention Research: A Glance at the Past, a Closer Review of the Present, and a Venture into the Future. Academy of Management Annals, 2(1), 231–274.
Huyghebaert, T., Gillet, N., Audusseau, O., & Fouquereau, E. (2019). Perceived career opportunities, commitment to the supervisor, social isolation: Their effects on nurses’ well-being and turnover. Journal of Nursing Management, 27(1), 207–214.
Jackofsky, E. F. (1984). Jackofsky, E.F. (1984) Turnover and job performance--An integrated process model.pdf. Academy of Management Review, 9(1), 74–83.
Karatepe, O. M., & Karadas, G. (2014). The effect of psychological capital on conflicts in the work-family interface, turnover and absence intentions. International Journal of Hospitality Management, 43, 132–143.
Karatepe, O. M., & Karadas, G. (2016). Service employees’ fit, work-family conflict, and work engagement. Journal of Services Marketing, 30(5), 554–566.
Knudsen, H. K., Ducharme, L. J., & Roman, P. M. (2009). Turnover Intention and Emotional Exhaustion “at the Top”: Adapting the Job Demands-Resources Model to Leaders of Addiction Treatment Organizations. Journal of Occupational Health Psychology, 14(1), 84–95.
Lambert, E. G., Hogan, N. L., Keena, L. D., Williamson, L., & Kim, B. (2017). Exploring the Association between Different Types of Social Support with Role Stress, Work–family Conflict, and Turnover Intent among Private Prison Staff. Journal of Applied Security Research, 12(2), 203–223.
Lee, Y. H. (2019). Emotional labor, teacher burnout, and turnover intention in high-school physical education teaching. European Physical Education Review, 25(1), 236–253.
Lee, Y. H., & Chelladurai, P. (2018). Emotional intelligence, emotional labor, coach burnout, job satisfaction, and turnover intention in sport leadership. European Sport Management Quarterly, 18(4), 393–412.
Li, N., Zhang, L., Xiao, G., Chen, J., & Lu, Q. (2019). The relationship between workplace violence, job satisfaction and turnover intention in emergency nurses. International Emergency Nursing, 2–7.
Liu, J., Zhu, B., Wu, J., & Mao, Y. (2019). Job satisfaction, work stress, and turnover intentions among rural health workers: a cross-sectional study in 11 western provinces of China. BMC Family Practice, 20(1), 1–11.
Ma, S., & Trigo, V. (2008). Winning the War for Managerial Talent in China: An Empirical Study. The Chinese Economy, 41(3), 34–57.
Macey, W. H., & Schneider, B. (2008). The Meaning of Employee Engagement. Industrial and Organizational Psychology, 1(01), 3–30.
Mazumdar-Shaw, K. (2018). Leveraging affordable innovation to tackle India’s healthcare challenge. IIMB Management Review, 30(1), 37–50.
Memon, M. A., Salleh, R., Nordin, S. M., Cheah, J. H., Ting, H., & Chuah, F. (2018). Person-organisation fit and turnover intention: the mediating role of work engagement. Journal of Management Development, 37(3), 285–298.
Mensah, R., & Kosi, I. (2016). Organizational commitment and turnover intentions of clinical laboratory scientists in Ghana. European Journal of Business and Management, 8(2), 164–172.
Meyer, J. P., Stanley, D. J., Herscovitch, L., & Topolnytsky, L. (2002). Affective, continuance, and normative commitment to the organization: A meta-analysis of antecedents, correlates, and consequences. Journal of Vocational Behavior, 61(1), 20–52.
Milliman, J., Gatling, A., & Kim, J. (Sunny). (2018). The effect of workplace spirituality on hospitality employee engagement, intention to stay, and service delivery. Journal of Hospitality and Tourism Management, 35, 56–65.
Mitchell, T. R., & Lee, T. W. (2013). The unfolding model of voluntary turnover and job embeddedness: Foundations for a comprehensive theory of attachment. Journal of Physiology and Biochemistry, 69(4), 687–695.
Mobley, W. H. (1977). Intermediate linkages in the relationship between job satisfaction and employee turnover. Journal of Applied Psychology, 62(2), 237–240.
Mobley, William H., Griffeth, R. W., Hand, H. H., & Meglino, B. M. (1979). Review and conceptual analysis of the employee turnover process. Psychological Bulletin, 86(3), 493–522.
Mobley, William H., Horner, S. O., & Hollingsworth, A. T. (1978). An evaluation of precursors of hospital employee turnover. Journal of Applied Psychology, 63(4), 408–414.
Model, M., Michaels, C. E., & Spector, P. E. (1982). Causes of employee turnover: a test of the Mobley, Griffeth, Hand and Meglino Model. Journal of Applied Psychology, 67(1), 53–59.
Mohamed Seada, A. (2017). Organizational Role Stress and Work Engagement Among Nurses in a Selected Hospital in Cairo. American Journal of Nursing Science, 6(1), 53.
Naidoo, R. (2018). Role stress and turnover intentions among information technology personnel in South Africa: The role of supervisor support. SA Journal of Human Resource Management, 21(1), 1–10.
Nasabi, N. A., & Bastani, P. (2018). The effect of quality of work life and job control on organizational indifference and turnover intention of nurses: a cross-sectional questionnaire survey. Central European Journal of Nursing and Midwifery, 9(4), 915.
Nazir, T., Ungku, U. N. B. U., Nawab, S., & Shah, S. F. H. (2016). Mediating role of organizational cynicism in relationship between role stressors and turnover intention: evidence from healthcare sector of Pakistan. International Review of Management and Marketing, 6(2), 199–204.
Nei, D., Snyder, L. A., & Litwiller, B. J. (2015). Promoting retention of nurses: A meta-Analytic examination of causes of nurse turnover. Health Care Management Review, 40(3), 237–253.
Ngo-Henha, P. E. (2017). A review of existing turnover intention theories. International Journal of Economics and Management Engineering, 11(11), 2760–2767.
Nwobia, I. E., & Aljohani, M. S. (2017). The Effect of Job Dissatisfaction and Workplace Bullying on Turnover Intention: Organization Climate and Group Cohesion as Moderators. International Journal of Marketing Studies, 9(3), 136.
Okodogbe, E. (2018). Relationship between human resources management practices and employee intention to leave healthcare organizations. ProQuest Dissertations and Theses. Northcentral University Graduate.
Ongori, H. (2007). Ongori_AJBM_2007. African Journal of Business Management, (June), 49–54.
Purdy, E. B. (2017). The relationship of quality of work life, work life balance and flexible working arrangements on female physician’s intent to leave their medical centre. ProQuest Dissertations and Theses. Central Michigan University.
Radwan, F. M. A., & Zhu, J. (2017). The Influence of Organizational Culture on Job Satisfaction and Turnover Intention in Oil Companies in Libya. ProQuest Dissertations and Theses. Nova Southeastern University.
Raj Arokiasamy, A. A. (2013). A Qualitative Study on Causes and Effects of Employee Turnover in the Private Sector in Malaysia. Middle-East Journal of Scientific Research Management and Social Sciences Plaza Teh Teng Seng. and Social Sciences, 16(2), 1532–1541.
Saks, A. M. (2019). Antecedents and consequences of employee engagement revisited. Journal of Organizational Effectiveness, 6(1), 19–38.
Samad, A., & Saufi, R. A. R. of T. M. and R. T. in T. L. (2017). A comparative review of turnover models and recent trends in turnover literature. Journal of Management and Marketing Review, 2(4), 27–35.
Scanlan, J. N., & Still, M. (2019). Relationships between burnout, turnover intention, job satisfaction, job demands and job resources for mental health personnel in an Australian mental health service. BMC Health Services Research, 19(1), 1–11.
Shareef, R. A., & Atan, T. (2018). The influence of ethical leadership on academic employees’ organizational citizenship behavior and turnover intention: mediating role of intrinsic motivation. Management Decision, 57(3), 583–605.
Shaw, J. D., Delery, J. E., Jenkins, G. D., & Gupta, N. (1998). An organization-level analysis of voluntary and involuntary turnover. Academy of Management Journal, 41(5), 511–525.
Sheehan, C., Tham, T. L., Holland, P., & Cooper, B. (2019). Psychological contract fulfilment, engagement and nurse professional turnover intention. International Journal of Manpower, 40(1), 2–16.
Siau, C. S., Wee, L. H., Ibrahim, N., Visvalingam, U., Ling Yeap, L. L., Yeoh, S. H., & Wahab, S. (2018). Predicting burnout and psychological distress risks of hospital healthcare workers. Malaysian Journal of Public Health Medicine, 2018(1), 125–136.
Steel, R. P., & Ovalle, N. K. (1984). A review and meta-analysis of research on the relationship between behavioral intentions and employee turnover. Journal of Applied Psychology, 69(4), 673–686.
Tennant, C. (2001). Work-related stress and depressive disorders. Journal of Psychosomatic Research, 51(5), 697–704.
Tett, R. P., & Meyer, J. P. (1993). Job Satisfaction, Organizational Commitment, Turnover Intention, and Turnover: Path Analyses Based on Meta‐Analytic Findings. Personnel Psychology, 46(2), 259–293.
Tnay, E., Othman, A. E. A., Siong, H. C., & Lim, S. L. O. (2013). The Influences of Job Satisfaction and Organizational Commitment on Turnover Intention. Procedia - Social and Behavioral Sciences, 97, 201–208.
van de Klundert, J., van Dongen-van den Broek, J., Yesuf, E. M., Vreugdenhil, J., & Yimer, S. M. (2018). ’We are planning to leave, all of us’-a realist study of mechanisms explaining healthcare employee turnover in rural Ethiopia. Human Resources for Health, 16(1), 1–13.
Van der Heijden, B. I. J. M., Peeters, M. C. W., Le Blanc, P. M., & Van Breukelen, J. W. M. (2018). Job characteristics and experience as predictors of occupational turnover intention and occupational turnover in the European nursing sector. Journal of Vocational Behavior, 108(June), 108–120.
Wang, I. A., Lee, B. W., & Wu, S. T. (2017). The relationships among work-family conflict, turnover intention and organizational citizenship behavior in the hospitality industry of Taiwan. International Journal of Manpower, 38(8), 1130–1142.
Wang, L., Cheng, M. Y., & Wang, S. (2018). Carrot or Stick? The Role of In-Group/Out-Group on the Multilevel Relationship Between Authoritarian and Differential Leadership and Employee Turnover Intention. Journal of Business Ethics, 152(4), 1069–1084.
Wong, Y. W., & Wong, Y. T. (2017). The effects of perceived organisational support and affective commitment on turnover intention: A test of two competing models. Journal of Chinese Human Resource Management, 8(1), 2–21.
Zhang, F., Luo, Z., Chen, T., Min, R., & Fang, P. (2017). Factors affecting turnover intentions among public hospital doctors in a middle-level city in central China. Australian Health Review, 41(2), 214–221.
How to Cite
HARUN, IFRAH. Factors Affecting Turnover Intention In Public Healthcare Workforce: A Conceptual Study. Asian Journal of Research in Business and Management, [S.l.], v. 2, n. 2, p. 76-85, june 2020. Available at: <https://myjms.mohe.gov.my/index.php/ajrbm/article/view/9613>. Date accessed: 02 july 2022.