Job satisfaction and nurses’ intention to stay with their current employer: The mediating role of work engagement
-
DOIhttp://dx.doi.org/10.21511/ppm.24(1).2026.06
-
Article InfoVolume 24 2026, Issue #1, pp. 69-82
- 13 Views
-
2 Downloads
This work is licensed under a
Creative Commons Attribution 4.0 International License
Type of the article: Research Article
Abstract
This study examines whether job satisfaction predicts nurses’ intention to stay with their employer and whether work engagement (conceptualized as vigor, dedication, and absorption) mediates this relationship. We conducted a two-phase repeated cross-sectional survey of hospital nurses in Slovakia to replicate and validate findings across time periods; data were collected in May–November 2022 (n = 742) and September–October 2024 (n = 500). The samples were comparable in demographic characteristics, and the results were consistent across both phases. Descriptive statistics and partial least squares structural equation modeling (PLS-SEM) were employed. Results showed that job satisfaction significantly predicted nurses’ intention to stay (β = 0.281, p < 0.001). Work engagement also positively predicted intention to stay and acted as a partial mediator between job satisfaction and intention to stay (indirect effect β = 0.142, p < 0.001). Among satisfaction facets, remuneration and benefits (standardized loading = 0.829) were the strongest predictors of retention, followed by managerial support (0.791), workload (0.787), and career advancement opportunities (0.783). Engagement was thus confirmed as a statistically significant mediator between job satisfaction and intention to stay. These findings quantify the pathway from satisfaction to intention to stay via engagement and prove the stability of these relationships over time, including during the period of changes brought about by the COVID-19 pandemic. Practically, targeted HR policies that strengthen satisfaction and engagement, especially through competitive pay and benefits, supportive supervision, effective communication, and clear developmental and career pathways, are essential to stabilize the nursing workforce and mitigate turnover.
Acknowledgments
This study was supported by the ESG project No. D12_2024, “The impact of human resource practices on the sustainability of the nursing workforce (nurses) in hospitals,” and was also conducted as part of the completed APVV project No. 19-0579, “Personnel management processes set up in hospitals and their impact on the migration of physicians and nurses to work abroad.”
- Keywords
-
JEL Classification (Paper profile tab)M12, J28, I18, M54
-
References56
-
Tables4
-
Figures3
-
- Figure 1. Conceptual model
- Figure 2. Factor model (2022) – the impact of satisfaction factors on nurses’ intention to stay
- Figure 3. Factor model (2024) – the impact of satisfaction factors on nurses’ intention to stay
-
- Table 1. Descriptive characteristics
- Table 2. CFA fit indices for the overall model of the first research phase (year 2022) and the second research phase (2024)
- Table 3. Regression weights and standard errors for the job satisfaction model and its impact on nurses’ intention to stay (2022)
- Table 4. Regression weights and standard errors for the job satisfaction model and its impact on nurses’ intention to stay (2024)
-
- Abugre, D., & Bhengu, B. R. (2024). Nurse managers’ perceptions of patient-centred care and its influence on quality nursing care and nurse job satisfaction: Empirical research qualitative. Nursing Open, 11(1), Article e2071.
- Ahn, Y. S., & Choi, J. S. (2023). Nurses’ perceptions of career ladder systems, job satisfaction and turnover intention: A cross-sectional study. Nursing Open, 10(1), 195-201.
- Alanazi, R., Bahari, G., Alzahrani, Z. A., Alhaidary, A., Alharbi, K., Albagawi, B. S., & Alanazi, N. H. (2023). Exploring the factors behind nurses’ decision to leave clinical practice: Revealing causes for leaving and approaches for enhanced retention. Healthcare, 11(24), Article 3104.
- Alenazy, F. S., Dettrick, Z., & Keogh, S. (2023). The relationship between practice environment, job satisfaction and intention to leave in critical care nurses. Nursing in Critical Care, 28(2), 167-176.
- Al-Khasawneh, A., & Khadar, B. A. (2021). Organizational conflicts in hospitals and their impact on employee turnover: A case study of Jordan. Problems and Perspectives in Management, 19(2), 206-216.
- Alziyadat, Z., & Obidat, A. (2022). The relationship between time management, job satisfaction, and job burnout among Jordanian medical staff during COVID-19. Problems and Perspectives in Management, 20(4), 396-406.
- Athamneh, S. (2024). Human resource management practices and their impact on healthcare workers’ job satisfaction and burnout in the Jordanian public sector. Problems and Perspectives in Management, 22(1), 634-648.
- Bae, S.-H. (2024). Nurse staffing, work hours, mandatory overtime, and turnover in acute care hospitals affect nurse job satisfaction, intent to leave, and burnout: A cross-sectional study. International Journal of Public Health, 69, Article 1607068.
- Bae, S-H. (2025). Association between nurse turnover and missed nursing care in acute care hospitals in South Korea. Frontiers in Medicine, 11, Article 1448839.
- Bakker, A. B., & Demerouti, E. (2017). Job demands–resources theory: Taking stock and looking forward. Journal of Occupational Health Psychology, 22(3), 273-285.
- Bakker, A. B., Demerouti, E., & Sanz-Vergel, A. (2023). Job demands–resources theory: Ten years later. Annual Review of Organizational Psychology and Organizational Behavior, 10, 25-53.
- Bentler, P. M. (1990). Comparative fit indexes in structural models. Psychological Bulletin, 107(2), 238-246.
- Bentler, P. M., & Bonett, D. G. (1980). Significance tests and goodness of fit in the analysis of covariance structures. Psychological Bulletin, 88(3), 588-606.
- Byrne, B. M. (1998). Structural equation modeling with Lisrel, Prelis, and Simplis: Basic concepts, applications, and programming (1st ed.). Psychology Press.
- Callado, A., Teixeira, G., & Lucas, P. (2023). Turnover intention and organizational commitment of primary healthcare nurses. Healthcare, 11(4), Article 521.
- Chang, C.-S. (2014). Moderating effects of nurses’ organizational justice between organizational support and organizational citizenship behaviors for evidence-based practice. Worldviews on Evidence-Based Nursing, 11(5), 332-340.
- Cho, H.-K., & Kim, B. (2022). Effect of nurses’ grit on nursing job performance and the double mediating effect of job satisfaction and organizational commitment. Healthcare, 10(2), Article 396.
- Conroy, N., Patton, D., Moore, Z. E. H., O’Connor, T., Nugent, L., & Derwin, R. (2023). The relationship between transformational leadership and staff nurse retention in hospital settings: A systematic review. Journal of Nursing Management.
- Dall’Ora, C., Saville, C., Rubbo, B., Turner, L., Jones, J., & Griffiths, P. (2022). Nurse staffing levels and patient outcomes: A systematic review of longitudinal studies. International Journal of Nursing Studies, 134, Article 104311.
- Danish, R. Q., Gohar, A., Ahmad, A., & Shaukat, S. (2017). Mediating role of work engagement in the relationship between job satisfaction and turnover intention: Empirical evidence from hospitals in Lahore, Pakistan. International Journal of Management Research and Emerging Sciences, 7(1).
- De Los Santos, J. A. A., & Labrague, L. J. (2021). Job engagement and satisfaction are associated with nurse caring behaviours: A cross-sectional study. Journal of Nursing Management, 29(7), 2234-2242.
- De Sul, S. I. R., & Lucas, P. R. M. B. (2020). Translation and validation of the anticipated turnover scale for the Portuguese cultural context. Nursing Open, 7(5), 1475-1481.
- Doleman, G., Twigg, D., Bayes, S., & Chivers, P. (2021). Paediatric nurses’ satisfaction with organisational communication, job satisfaction, and intention to stay: A structural equation modelling analysis. Collegian, 28(4), 376-384.
- Farahani, M. A., Nargesi, S., Saniee, N., Dolatshahi, Z., Heidari Beni, F., & Shariatpanahi, S. (2024). Factors affecting nurses’ retention during the COVID-19 pandemic: A systematic review. Human Resources for Health, 22(1), Article 78.
- Galanis, P., Moisoglou, I., Papathanasiou, I. V., Malliarou, M., Katsiroumpa, A., Vraka, I., Siskou, O., Konstantakopoulou, O., & Kaitelidou, D. (2024). Association between organizational support and turnover intention in nurses: A systematic review and meta-analysis. Healthcare, 12(3), Article 291.
- Gilles, I., Mabire, C., Perriraz, M., & Peytremann-Bridevaux, I. (2021). Workplace well-being and intent to stay by health care workers reassigned during the first COVID-19 wave: Results of a Swiss survey. International Journal of Environmental Research and Public Health, 18(17), Article 8976.
- Hahm, S. Y., Gu, M., & Sok, S. (2024). Influences of communication ability, organizational intimacy, and trust among colleagues on job satisfaction of nurses in comprehensive nursing care service units. Frontiers in Public Health, 12, Article 1354972.
- House, S., Wilmoth, M., & Stucky, C. (2022). Job satisfaction among nurses and physicians in an Army hospital: A content analysis. Nursing Outlook, 70(4), 601-615.
- Hu, L.-t., & Bentler, P. M. (1998). Fit indices in covariance structure modeling: Sensitivity to underparameterized model misspecification. Psychological Methods, 3(4), 424-453.
- Hua, J., Kondo, A., Wang, C., & Ganchuluun, S. (2023). Job satisfaction, intention to leave, and related factors among foreign-educated nurses in Japan: A cross-sectional study. Journal of Nursing Management.
- Jimenez-Caceres, A., Agusti-Boada, A., Caro-Benito, C., & Monistrol, O. (2025). Relationship between different leadership styles of nursing managers and nurses’ turnover intention in hospitals: An integrative review. BMC Nursing, 24, Article 939.
- Jöreskog, K. G., & Sörbom, D. (1993). LISREL 8: Structural equation modeling with the SIMPLIS command language. Scientific Software International.
- Khraim, H. (2023). The impact of organizational change on employee turnover intentions at private hospitals: The moderating role of emotional intelligence. Problems and Perspectives in Management, 21(4), 52-62.
- Kroczek, M., & Späth, J. (2022). The attractiveness of jobs in the German care sector: Results of a factorial survey. The European Journal of Health Economics, 23(9), 1547-1562.
- Lee, J. Y., & Lee, M. H. (2022). Structural model of retention intention of nurses in small- and medium-sized hospitals: Based on Herzberg’s motivation-hygiene theory. Healthcare, 10(3), Article 502.
- Marsh, H. W., Hau, K. T., Balla, J. R., & Grayson, D. (1998). Is more ever too much? The number of indicators per factor in confirmatory factor analysis. Multivariate Behavioral Research, 33(2), 181-220.
- Marsh, H. W., Hau, K. T., & Wen, Z. (2004). In search of golden rules: Comment on hypothesis-testing approaches to setting cutoff values for fit indexes and dangers in overgeneralizing Hu and Bentler’s (1999) findings. Structural Equation Modeling: A Multidisciplinary Journal, 11(3), 320-341.
- Mirzaei, A., Imashi, R., Saghezchi, R. Y., Jafari, M. J., & Nemati-Vakilabad, R. (2024). The relationship of perceived nurse manager competence with job satisfaction and turnover intention among clinical nurses: An analytical cross-sectional study. BMC Nursing, 23(1), Article 528.
- Oates, J., Topping, A., Ezhova, I., Wadey, E., & Rafferty, A. M. (2020). An integrative review of nursing staff experiences in high secure forensic mental health settings: Implications for recruitment and retention strategies. Journal of Advanced Nursing, 76(11), 2897-2908.
- Othman, M. I., Khalifeh, A., Oweidat, I., & Nashwan, A. J. (2024). The relationship between emotional intelligence, job satisfaction, and organizational commitment among first-line nurse managers in Qatar. Journal of Nursing Management.
- Pursio, K., Kankkunen, P., Mikkonen, S., & Kvist, T. (2024). Organizational characteristics of nursing practice environments related to registered nurses’ professional autonomy and job satisfaction in two Finnish Magnet-aspiring hospitals: Structural equation modeling study. BMC Nursing, 23(1), Article 100.
- Rhemtulla, M., Brosseau-Liard, P. É., & Savalei, V. (2012). When can categorical variables be treated as continuous? A comparison of robust continuous and categorical SEM estimation methods under suboptimal conditions. Psychological Methods, 17(3), 354-373.
- Rutledge, D. N., Douville, S., Winokur, E., Drake, D., & Niedziela, D. (2021). Impact of engagement factors on nurses’ intention to leave hospital employment. Journal of Nursing Management, 29(6), 1554-1564.
- Şahin, M., Bektaş, G., Nal, M., & Küçükkurt, A. C. (2025). The mediating role of job satisfaction related to nurse-nurse collaboration and turnover intention. BMC Nursing, 24(1), Article 235.
- Schermelleh-Engel, K., Moosbrugger, H., & Müller, H. (2003). Evaluating the fit of structural equation models: Tests of significance and descriptive goodness-of-fit measures. Methods of Psychological Research Online, 8(2), 23-74.
- Smith, S., Lapkin, S., Halcomb, E., & Sim, J. (2023). Job satisfaction among small rural hospital nurses: A cross-sectional study. Journal of Nursing Scholarship, 55(1), 378-387.
- Spector, P. E. (2022). Job satisfaction: From assessment to intervention (1st ed.). Routledge.
- Sugawara, D., Mizuno, M., Tani, S., Fukiya, K., & Sato, J. (2023). Relationship between self-compassion and turnover intention among early career nurses in Japan. Japanese Psychological Research, 65(4), 413-422.
- Torun, E. D. (2020). Educational use of social media in higher education: Gender and social networking sites as the predictors of consuming, creating, and sharing content. Acta Educationis Generalis, 10(2).
- Wei, H., Horsley, L., Cao, Y., Haddad, L. M., Hall, K. C., Robinson, R., Powers, M., & Anderson, D. G. (2023). The associations among nurse work engagement, job satisfaction, quality of care, and intent to leave: A national survey in the United States. International Journal of Nursing Sciences, 10(4), 476-484.
- Xia, Y., & Yang, Y. (2019). RMSEA, CFI, and TLI in structural equation modeling with ordinal data: The story they tell depends on the estimation method. Behavior Research Methods, 51(1), 409-428.
- Xue, B., Feng, Y., Hu, Z., Chen, Y., Zhao, Y., Li, X., Yang, Y., Zhang, J., Zhang, Y., & Luo, H. (2024). Assessing the mediation pathways: How decent work affects turnover intention through job satisfaction and burnout in nursing. International Nursing Review, 71(4), 860-867.
- Zahednezhad, H., Hoseini, M. A., Ebadi, A., Farokhnezhad Afshar, P., & Ghanei Gheshlagh, R. (2021). Investigating the relationship between organizational justice, job satisfaction, and intention to leave the nursing profession: A cross-sectional study. Journal of Advanced Nursing, 77(4), 1741-1750.
- Zhang, M., Chen, H., Wang, N., Li, Y., Li, X., & Liu, Y. (2023). The mediating role of job satisfaction between psychological capital and work engagement among Chinese nurses during COVID-19 outbreak: A comparative study between nurse specialists and general nurses. Frontiers in Psychiatry, 13, Article 990216.
- Zhang, Y., Zhang, X., Xu, N., & Yun, E. (2021). Nurses’ turnover intention in secondary hospitals in China: A structural equation modelling approach. Journal of Nursing Management, 29(7), 2216-2224.
- Zhao, Y., Lu, H., Zhu, X., & Xiao, G. (2025). Job satisfaction among hospital nurses: An updated literature review. International Journal of Nursing Studies, 162, Article 104964.


