Psikiyatri Hemşirelerinin İş Ortamının İşten Ayrılma Niyeti Üzerindeki Etkisi: Tükenmişliğin Aracı Rolü

Year 2025, Volume: 14 Issue: 3, 1153 - 1164, 25.09.2025

Nurten Arslan Isık , İrem Nur Sandıkçı , Beyza Şekeroğlu , Şevval Demirci , Dılşa Azizoğlu Keleş , Taras Kotyk

https://doi.org/10.37989/gumussagbil.1608727

Abstract

Bu çalışma, psikiyatri hemşirelerinde iş ortamının işten ayrılma niyeti üzerindeki etkisini ve bu ilişkide tükenmişliğin aracı rolünü incelemeyi amaçlamaktadır. Kesitsel bir tasarıma sahip olan çalışmaya, Türkiye’deki çeşitli psikiyatri hastanelerinde görev yapan 168 psikiyatri hemşiresi katılmıştır. Veriler, Demografik Bilgi Formu, Hemşirelik İş Ortamı İndeksi (NWEI), Maslach Tükenmişlik Envanteri (MBI) ve İşten Ayrılma Niyeti Ölçeği kullanılarak toplanmıştır. Değişkenler arasındaki ilişkileri değerlendirmek için Spearman korelasyon analizi ve yapısal eşitlik modellemesi (SEM) uygulanmıştır.
Bulgular, hemşirelik iş ortamının işten ayrılma niyeti üzerinde negatif bir etkisi olduğunu göstermektedir (β = -0.179, p < .009). Buna karşılık, tükenmişliğin işten ayrılma niyeti üzerinde pozitif bir etkisi olduğu tespit edilmiştir (β = 0.501, p < .001). Ayrıca tükenmişliğin, iş ortamı ile işten ayrılma niyeti arasındaki ilişkide anlamlı bir aracı rol oynadığı belirlenmiştir (β = -0.221, p < .001). Psikiyatri hemşirelerinin iş ortamlarının iyileştirilmesi, tükenmişliğin azaltılması ve işten ayrılma niyetinin düşürülmesi açısından büyük önem taşımaktadır. Yönetsel destek, etkili liderlik ve yeterli kaynakların sağlanması, işten ayrılma niyetini azaltmada kritik rol oynayabilir.

Keywords

Psikiyatri Hemşireleri , Hemşirelik İş Ortamı , Tükenmişlik , İşten Ayrılma Niyeti

Effects of the Work Environment on Turnover Intentions among Psychiatric Nurses: The Mediating Role of Burnout

Abstract

This study aims to examine the impact of the work environment on turnover intention among psychiatric nurses and to investigate the mediating role of burnout in this relationship. This cross-sectional study included 168 psychiatric nurses working in various psychiatric hospitals in Turkey. Data were collected via a demographic information form, the Nursing Work Environment Index (NWEI), the Maslach Burnout Inventory (MBI), and the Turnover Intention Scale. Spearman correlation analysis and structural equation modeling (SEM) were employed to assess the relationships between the variables. Our findings indicate that the nursing work environment has a negative effect on turnover intention (β = -0.179, p < .009). Conversely, burnout positively affects turnover intention (β = 0.501, p < .001). Additionally, burnout was found to significantly mediate the relationship between the work environment and turnover intention (β= -0.221, p < .001). Improving the work environment of psychiatric nurses is critical for reducing burnout and lowering turnover intention. Managerial support, leadership, and enhanced resources may be crucial in lowering turnover intention.

Keywords

Psychiatric Nurses , Nursing Work Environment , Burnout , Turnover Intention

References

• 1. Schultz AB, Chen CY, Edington DW. The cost and impact of health conditions on presenteeism to employers: a review of the literature. Pharmacoeconomics. 2009;27(5):365-378. doi:10.2165/00019053-200927050-00002
• 2. Laschinger HK, Leiter MP. The impact of nursing work environments on patient safety outcomes: the mediating role of burnout/engagement. J Nurs Adm. 2006;36(5):259-267. doi:10.1097/00005110-200605000-00019
• 3. Alexiou A, Fahy K, Mason K, et al. Local government funding and life expectancy in England: a longitudinal ecological study. Lancet Public Health. 2021;6(9) doi:10.1016/S2468-2667(21)00110-9
• 4. Okan T, Özbek FM. İş Yükü Talebi, İş Tatminsizliği ve İşten Ayrılma Niyeti Arasındaki İlişkilerde İş-Aile Çatışması ve İş Stresinin Ara Değişken Rolü: Sağlık Çalışanları Örneği. Gümüshane University Electronic Journal of the Institute of Social Science. 2016; 7(17)
• 5. Chen X, Ran L, Zhang Y, et al. Moderating role of job satisfaction on turnover intention and burnout among workers in primary care institutions: a cross-sectional study. BMC Public Health. 2019;19:1-10.
• 6. Laschinger HKS, Fida R. A time-lagged analysis of the effect of authentic leadership on workplace bullying, burnout, and occupational turnover intentions. Eur J Work Organ Psychol. 2014;23(5):739-753.
• 7. Edwards D, Burnard P. A systematic review of stress and stress management interventions for mental health nurses. J Adv Nurs. 2003;42(2):169-200.
• 8. Aiken LH, Sermeus W, Van den Heede K, et al. Patient safety, satisfaction, and quality of hospital care: cross-sectional surveys of nurses and patients in 12 countries in Europe and the United States. BMJ. 2012;344
• 9. Park K, Jang A. Factors affecting the resilience of new nurses in their working environment. Int J Environ Res Public Health. 2022;19(9):5158.
• 10. Aiken LH, Clarke SP, Sloane DM, Sochalski J, Silber JH. Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. JAMA.2002;288(16):1987193.
• 11. Ministry of Health. National Mental Health Plan (2011–2023). Republic of Turkey Ministry of Health; 2011.
• 12. Lake ET. Development of the practice environment scale of the Nursing Work Index. Res Nurs Health. 2002;25(3):176-188. doi:10.1002/nur.10032
• 13. Türkmen E, Badır A, Balcı S, Akkuş-Topçu S. Hemşirelik iş indeksi- hemşirelik çalışma ortamını değerlendirme ölçeğinin Türkçeye uyarlanması: Güvenilirlik ve geçerlilik çalışması. Hemşirelikte Araştırma ve Geliştirme Dergisi. 2011;2:5-20.
• 14. Wayne SJ, Shore LM, Liden RC. Perceived organizational support and leader-member exchange: A social exchange perspective. Acad Manage J. 1997;40(1):82-111.
• 15. Küçükusta D. Konaklama İşletmelerinde İş-Yaşam Dengesi Sorunları ve Çözüme Yönelik Yaklaşımlar. Dokuz Eylül Üniversitesi Sosyal Bilimler Enstitüsü Dergisi. 2007;9(3):243-268.
• 16. Maslach C, Jackson SE. The measurement of experienced burnout. J Organ Behav. 1981;2(2):99-113.
• 17. Ergin C. Doktor ve hemşirelerde tükenmişlik ve Maslach Tükenmişlik Ölçeğinin uyarlanması [Burnout among doctors and nurses and adaptation of the Maslach Burnout Inventory]. In: Proceedings of the VII. Ulusal Psikoloji Kongresi; 1992; Ankara, Turkey.
• 18. Johnson C, Delaney KR, Cirpili A, Marriott S, O’Connor J. American Psychiatric Nurses Association Position: Staffing Inpatient Psychiatric Units. J Am Psychiatr Nurses Assoc. Published online 2023. doi:10.1177/10783903231198247
• 19. Warshawsky NE, Havens DS. Global use of the Practice Environment Scale of the Nursing Work Index. doi:10.1097/NNR.0b013e3181ffa79c Nurs Res. 2011;60(1):17-31.
• 20. Johnson C, Delaney KR, Cirpili A, Marriott S, O’Connor J. American Psychiatric Nurses Association Position: Staffing Inpatient Psychiatric Units. J Am Psychiatr Nurses Assoc. Published online 2023. doi:10.1177/10783903231198247 21. Nantsupawat A, Nantsupawat R, Kunaviktikul W, Turale S, Poghosyan L. Nurse burnout, nurse‐reported quality of care, and patient outcomes in Thai hospitals. J Nurs Scholarsh. 2016;48(1):83-90.
• 22. Rosenstein AH, O'Daniel M. Disruptive behavior and clinical outcomes: perceptions of nurses and physicians: Nurses, physicians, and administrators say that clinicians' disruptive behavior has negative effects on clinical outcomes. Am J Nurs. 2005;105(1):54-64.
• 23. Kramer M, Schmalenberg CE. Magnet hospital nurses describe control over nursing practice. West J Nurs Res. 2003;25(4):434-452.
• 24. Manojlovich M. Promoting nurses' self-efficacy: a leadership strategy to improve practice. J Nurs Adm. 2005;35(5):271-278. doi:10.1097/00005110-200505000-00011
• 25. Hamaideh SH. Stressors and reactions to stressors among university students. Int J Soc Psychiatry. 2011;57(1):69-80. doi:10.1177/0020764009348442
• 26. Kaddourah B, Abu-Shaheen AK, Al-Tannir M. Quality of nursing work life and turnover intention among nurses of tertiary care hospitals in Riyadh: a cross-sectional survey. BMC Nurs. 2018;17:43. doi:10.1186/s12912-018-0312-0
• 27. McTiernan K, McDonald N. Occupational stressors, burnout and coping strategies between hospital and community psychiatric nurses in a Dublin region. J Psychiatr Ment Health Nurs. 2015;22(3):208-218.
• 28. Bamford M, Wong CA, Laschinger H. The influence of authentic leadership and areas of worklife on work engagement of registered nurses. J Nurs Manag. 2013;21(3):529540. doi:10.1111/j.1365-2834.2012.01399.x
• 29. Laschinger HKS, Fida R. New nurses burnout and workplace wellbeing: The influence of authentic leadership and psychological capital. Burn Res. 2014;1(1):19-28.
• 30. O'Brien-Pallas L, Murphy GT, Shamian J, Li X, Hayes LJ. Impact and determinants of nurse turnover: a pan-Canadian study. J Nurs Manag. 2010;18(8):1073-1086. doi:10.1111/j.1365-2834.2010.01167.x
• 31. McHugh MD, Kutney-Lee A, Cimiotti JP, Sloane DM, Aiken LH. Nurses' widespread job dissatisfaction, burnout, and frustration with health benefits signal problems for patient care. Health doi:10.1377/hlthaff.2010.0100 Aff (Millwood). 2011;30(2):202-210.
• 32. Schaufeli WB, Bakker AB. Job demands, job resources, and their relationship with burnout and engagement: A multi‐sample study. J Organ Behav. 2004;25(3):293-315.
• 33. Hanrahan NP, Aiken LH. Psychiatric nurse reports on the quality of psychiatric care in general hospitals. Qual Manag doi:10.1097/01.QMH.0000326725.55460.af Health Care. 2008;17(3):210-217.
• 34. Rössler W. Stress, burnout, and job dissatisfaction in mental health workers. Eur Arch Psychiatry Clin Neurosci. 2012;262(Suppl 2):65-69. doi:10.1007/s00406-012-0353-4
• 35. Poghosyan L, Clarke SP, Finlayson M, Aiken LH. Nurse burnout and quality of care: Cross-national investigation in six countries. Res Nurs Health. 2010;33(4):288-298. doi:10.1002/nur.20383