ORGANIZATIONAL AND INDIVIDUAL DETERMINANTS OF QUIET QUITTING AMONG HEALTHCARE WORKERS: AN UPDATED SYSTEMATIC REVIEW OF EMPIRICAL STUDIES

Öz

Objective: This review aimed to provide an updated synthesis of the determinants, outcomes, and managerial implications reported in empirical studies that directly measured quiet quitting among healthcare workers. Methods: The review was conducted in accordance with PRISMA 2020. A structured search of the Web of Science Core Collection was completed in May 2026. Peer-reviewed studies in English or Turkish were eligible when they included healthcare workers, explicitly measured quiet quitting, and reported original data. Methodological quality was assessed using design-appropriate Joanna Briggs Institute tools and the Mixed Methods Appraisal Tool. Findings were integrated through directed thematic synthesis. Results: Twenty-seven eligible studies were included. Most evidence was derived from nursing samples and cross-sectional designs. Heavy workload, understaffing, burnout, poor work environments, workplace bullying, and low organizational support were positively associated with quiet quitting. Emotional intelligence, moral and psychological resilience, supportive leadership, and quality of work life were reported as protective resources. Evidence directly linking quiet quitting to objective patient outcomes remained limited. Conclusion: Quiet quitting should not be reduced to an individual lack of motivation. It should be monitored as an organizational early-warning indicator related to work design, leadership, and employee well-being. Longitudinal and multi-professional studies using objective care outcomes are required.

Anahtar Kelimeler

• Quiet quitting
• healthcare workers
• nurses
• burnout
• systematic review.

SAĞLIK ÇALIŞANLARINDA SESSİZ İSTİFANIN ÖRGÜTSEL VE BİREYSEL BELİRLEYİCİLERİ: AMPİRİK ARAŞTIRMALARIN GÜNCELLENMİŞ SİSTEMATİK DERLEMESİ

Öz

Amaç: Sağlık çalışanlarında sessiz istifayı doğrudan ölçen ampirik araştırmalarda bildirilen belirleyicilerin, sonuçların ve yönetimsel çıkarımların güncellenmiş biçimde sentezlenmesi amaçlanmıştır. Yöntem: Sistematik derleme PRISMA 2020 doğrultusunda yürütülmüştür. Web of Science Core Collection veri tabanında Mayıs 2026 tarihinde yapılandırılmış tarama gerçekleştirilmiştir. Sağlık çalışanlarını kapsayan, sessiz istifayı açık biçimde ölçen ve özgün veri sunan Türkçe veya İngilizce hakemli çalışmalar değerlendirilmiştir. Çalışmaların yöntemsel niteliği tasarıma uygun Joanna Briggs Institute ve Mixed Methods Appraisal Tool ölçütleriyle incelenmiş, bulgular yönlendirilmiş tematik sentezle birleştirilmiştir. Bulgular: Uygunluk ölçütlerini karşılayan 27 araştırma senteze alınmıştır. Kanıtların çoğunun hemşire örneklemlerine ve kesitsel tasarımlara dayandığı belirlenmiştir. Yüksek iş yükü, yetersiz personel, tükenmişlik, olumsuz çalışma ortamı, iş yeri zorbalığı ve düşük örgütsel destek sessiz istifayla olumlu yönde ilişkilendirilmiştir. Duygusal zekâ, ahlaki ve psikolojik dayanıklılık, destekleyici liderlik ile nitelikli çalışma yaşamı koruyucu kaynaklar olarak bildirilmiştir. Sonuç: Sessiz istifanın yalnızca bireysel motivasyon eksikliği olarak değerlendirilmemesi; iş tasarımı, liderlik ve çalışan refahıyla ilişkili örgütsel bir erken uyarı göstergesi olarak izlenmesi gerektiği sonucuna ulaşılmıştır.

Anahtar Kelimeler

• Sessiz istifa
• sağlık çalışanları
• hemşireler
• tükenmişlik
• sistematik derleme

Kaynakça

1. Abdullah, A., & Bangcola, A. (2024). Investigating the perspectives of millennial and Gen Z nurses on quiet quitting in Marawi City, Lanao del Sur, Philippines. The Malaysian Journal of Nursing, 16(1), 135–148. https://doi.org/10.31674/mjn.2024.v16i01.014
2. Aromataris, E., & Munn, Z. (Eds.). (2020). JBI manual for evidence synthesis. JBI. https://synthesismanual.jbi.global
3. Arvaniti, P., Antoniadou, M., & Galanis, P. (2024). Silent disengagement: Investigating quiet quitting among Greek healthcare professionals. International Journal of Caring Sciences, 17(3), 1245–1253.
4. Bakker, A. B., & Demerouti, E. (2007). The job demands-resources model: State of the art. Journal of Managerial Psychology, 22(3), 309–328. https://doi.org/10.1108/02683940710733115
5. Bakker, A. B., & Demerouti, E. (2017). Job demands–resources theory: Taking stock and looking forward. Journal of Occupational Health Psychology, 22(3), 273–285. https://doi.org/10.1037/ocp0000056
6. Belli, M., & Erçelik, Z. E. (2026). Moral resilience and quiet quitting tendencies among pediatric nurses: A multiple linear regression study. Journal of Pediatric Nursing, 87, 154–159. https://doi.org/10.1016/j.pedn.2026.01.010
7. Boy, Y., Sürmeli, M., & Çam, F. (2026). Prevalence and predictors of quiet quitting among healthcare professionals: A scale development and validation study. BMC Psychology, 14, 457. https://doi.org/10.1186/s40359-026-04209-x
8. Crawford, E. R., LePine, J. A., & Rich, B. L. (2010). Linking job demands and resources to employee engagement and burnout: A theoretical extension and meta-analytic test. Journal of Applied Psychology, 95(5), 834–848. https://doi.org/10.1037/a0019364

9. Danacı, E., Özbudak Arıca, E., & Kavalalı Erdoğan, T. (2026). The relationship between stress of conscience and quiet quitting in nurses: The mediating role of compassion fatigue. Healthcare, 14(3), 316. https://doi.org/10.3390/healthcare14030316
10. El-Sayed, B. K. M., Asal, M. G. R., & El-Sayed, A. A. I. (2026). Navigating quiet quitting among critical care nurses in the digital era: The impact of techno-stress and digital resilience. Nursing in Critical Care, 31(1), e70273. https://doi.org/10.1111/nicc.70273
11. Galanis, P., Katsiroumpa, A., Vraka, I., Siskou, O., Konstantakopoulou, O., Moisoglou, I., … Kaitelidou, D. (2023). The quiet quitting scale: Development and initial validation. AIMS Public Health, 10(4), 828–848. https://doi.org/10.3934/publichealth.2023055
12. Galanis, P., Katsiroumpa, A., Moisoglou, I., Kalogeropoulou, M., Gallos, P., & Vraka, I. (2024a). Emotional intelligence protects nurses against quiet quitting, turnover intention, and job burnout. AIMS Public Health, 11(2), 601–613. https://doi.org/10.3934/publichealth.2024030
13. Galanis, P., Katsiroumpa, A., Vraka, I., Siskou, O., Konstantakopoulou, O., Katsoulas, T., … Kaitelidou, D. (2024b). Nurses quietly quit their job more often than other healthcare workers: An alarming issue for healthcare services. International Nursing Review, 71(4), 850–859. https://doi.org/10.1111/inr.12931
14. Galanis, P., Moisoglou, I., Katsiroumpa, A., Vraka, I., Siskou, O., Konstantakopoulou, O., & Kaitelidou, D. (2024c). Moral resilience reduces levels of quiet quitting, job burnout, and turnover intention among nurses: Evidence in the post-COVID-19 era. Nursing Reports, 14(1), 254–266. https://doi.org/10.3390/nursrep14010020
15. Galanis, P., Moisoglou, I., Katsiroumpa, A., Malliarou, M., Vraka, I., Gallos, P., … Papathanasiou, I. V. (2024d). Impact of workplace bullying on quiet quitting in nurses: The mediating effect of coping strategies. Healthcare, 12(7), 797. https://doi.org/10.3390/healthcare12070797
16. Galanis, P., Moisoglou, I., Katsiroumpa, A., Gallos, P., Kalogeropoulou, M., Meimeti, E., & Vraka, I. (2024e). Quiet quitting among nurses increases their turnover intention: Evidence from Greece in the post-COVID-19 era. Healthcare, 12(1), 79. https://doi.org/10.3390/healthcare12010079
17. Galanis, P., Moisoglou, I., Katsiroumpa, A., Gallos, P., Kalogeropoulou, M., Meimeti, E., & Vraka, I. (2025a). Workload increases nurses’ quiet quitting, turnover intention, and job burnout: Evidence from Greece. AIMS Public Health, 12(1), 44–55. https://doi.org/10.3934/publichealth.2025004
18. Galanis, P., Katsiroumpa, A., Vraka, I., Siskou, O., Konstantakopoulou, O., Katsoulas, T., … Kaitelidou, D. (2025b). The influence of job burnout on quiet quitting among nurses: The mediating effect of job satisfaction. International Journal of Nursing Practice, 31(5), e70057. https://doi.org/10.1111/ijn.70057
19. Ghahramani, S., Nemati, A., Hazrati, M., Gholami, M., Eskandari, A., Gholami, H., & Bagheri Lankarani, K. (2026). Quiet quitting of job in nurses working in hospitals: A multicenter study in Iran. Brain and Behavior, 16(5), e71439. https://doi.org/10.1002/brb3.71439
20. Gökkaya, D. (2024). İşe bağlı duygusal tükenmişliğin sessiz istifa üzerine etkisinde çalışma yaşam kalitesinin aracılık rolü: Sağlık çalışanlarında bir araştırma. Business & Management Studies: An International Journal, 12(3), 644–662. https://doi.org/10.15295/bmij.v12i3.2414
21. Gün, İ., Balsak, H., & Ayhan, F. (2025a). Mediating effect of job burnout on the relationship between organisational support and quiet quitting in nurses. Journal of Advanced Nursing, 81(8), 4644–4652. https://doi.org/10.1111/jan.16599
22. Gün, İ., Çetinkaya Kutun, F., & Söyük, S. (2025b). Mediating effect of turnover intention on the relationship between job burnout and quiet quitting in nurses. Journal of Advanced Nursing, 81(10), 6569–6577. https://doi.org/10.1111/jan.16807
23. Hobfoll, S. E., Halbesleben, J., Neveu, J.-P., & Westman, M. (2018). Conservation of resources in the organizational context: The reality of resources and their consequences. Annual Review of Organizational Psychology and Organizational Behavior, 5, 103–128. https://doi.org/10.1146/annurev-orgpsych-032117-104640
24. Janes, G., Mills, T., Budworth, L., Johnson, J., & Lawton, R. (2021). The association between health care staff engagement and patient safety outcomes: A systematic review and meta-analysis. Journal of Patient Safety, 17(3), 207–216. https://doi.org/10.1097/PTS.0000000000000807
25. Kahn, W. A. (1990). Psychological conditions of personal engagement and disengagement at work. Academy of Management Journal, 33(4), 692–724. https://doi.org/10.5465/256287
26. Koçak, O., Boz, C., Aksoy, B., Aksan, E., Özişli, Ö., & Solmaz, U. (2026). The impact of quality of work life on quiet quitting in healthcare workers: The mediating and moderating effects of compassion fatigue and psychological resilience. Work, 84(2), 551–561. https://doi.org/10.1177/10519815251401877
27. Li, L. Z., Yang, P., Singer, S. J., Pfeffer, J., Mathur, M. B., & Shanafelt, T. (2024). Nurse burnout and patient safety, satisfaction, and quality of care: A systematic review and meta-analysis. JAMA Network Open, 7(11), e2443059. https://doi.org/10.1001/jamanetworkopen.2024.43059
28. Marzocchi, I., Nielsen, K., Di Tecco, C., Vignoli, M., Ghelli, M., Ronchetti, M., & Iavicoli, S. (2024). Job demands and resources and their association with employee well-being in the European healthcare sector: A systematic review and meta-analysis. Work & Stress, 38(3), 293–320. https://doi.org/10.1080/02678373.2024.2308812
29. Moisoglou, I., Katsiroumpa, A., Prasini, I., Gallos, P., Kalogeropoulou, M., & Galanis, P. (2024). Innovation support reduces quiet quitting and improves innovative behavior and innovation outputs among nurses. Nursing Reports, 14(4), 2618–2628. https://doi.org/10.3390/nursrep14040193
30. Moisoglou, I., Katsiroumpa, A., Katsapi, A., Konstantakopoulou, O., & Galanis, P. (2025a). Poor nurses’ work environment increases quiet quitting and reduces work engagement: A cross-sectional study in Greece. Nursing Reports, 15(1), 19. https://doi.org/10.3390/nursrep15010019
31. Moisoglou, I., Katsiroumpa, A., Konstantakopoulou, O., Papathanasiou, I. V., Prasini, I., Rekleiti, M., & Galanis, P. (2025b). Resilience protects nurses from workplace gaslighting and quiet quitting, and improves their work engagement: A cross-sectional study in Greece. Healthcare, 13(16), 2064. https://doi.org/10.3390/healthcare13162064
32. Moisoglou, I., Katsiroumpa, A., Papathanasiou, I. V., Konstantakopoulou, O., Katharaki, M., Malliarou, M., … Galanis, P. (2025c). Engaging leadership reduces quiet quitting and improves work engagement: Evidence from nurses in Greece. Nursing Reports, 15(7), 247. https://doi.org/10.3390/nursrep15070247
33. Mokkink, L. B., de Vet, H. C. W., Prinsen, C. A. C., Patrick, D. L., Alonso, J., Bouter, L. M., & Terwee, C. B. (2018). COSMIN Risk of Bias checklist for systematic reviews of Patient-Reported Outcome Measures. Quality of Life Research, 27(5), 1171–1179. https://doi.org/10.1007/s11136-017-1765-4
34. Mutlu, H., & Baykara Mat, S. T. (2025). Sağlık çalışanlarında sessiz istifa: Sistematik derleme. Sağlık Bilimleri Üniversitesi Hemşirelik Dergisi, 7(3), 269–282. https://doi.org/10.48071/sbuhemsirelik.1739173
35. Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., … Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372, n71. https://doi.org/10.1136/bmj.n71
36. Prajapati, R., Rana, H., Palladino, F. P., & Thapa, P. (2024). Resilience and well-being among nurses in selected hospitals, Kathmandu. Journal of Healthcare Management and Leadership, (1), 1–8. https://doi.org/10.35345/johmal.1297216
37. Rinaldi, S., & Pomarolli, E. (2025). Quiet quitting among nurses: A case study in a Northern Italian hospital. Nursing Reports, 15(7), 239. https://doi.org/10.3390/nursrep15070239
38. Schaufeli, W. B., Salanova, M., González-Romá, V., & Bakker, A. B. (2002). The measurement of engagement and burnout: A two sample confirmatory factor analytic approach. Journal of Happiness Studies, 3, 71–92. https://doi.org/10.1023/A:1015630930326
39. Stankovic, M., & Slavkovic, M. (2025). Quality of work life determinants of healthcare professionals’ quiet quitting: Towards individual difference. Healthcare, 13(13), 1547. https://doi.org/10.3390/healthcare13131547
40. Tiryaki Şen, H., Yurtsever, D., & Polat, Ş. (2024). Sessiz istifa ve sessiz işten çıkarma ölçeklerinin Türkçede geçerlik ve güvenirlik çalışması: Hemşireler üzerinde bir araştırma. Sağlık ve Hemşirelik Yönetimi Dergisi, 11(2), 344–353. https://doi.org/10.54304/SHYD.2024.90187
41. Toska, A., Dimitriadou, I., Togas, C., Nikolopoulou, E., Fradelos, E. C., Papathanasiou, I. V., … Saridi, M. (2025). Quiet quitting in the hospital context: Investigating conflicts, organizational support, and professional engagement in Greece. Nursing Reports, 15(2), 38. https://doi.org/10.3390/nursrep15020038
42. Xu, Q., Yu, Z., Fan, S., Wu, Y., Wang, Y., Zou, D., … Zhang, X. (2025). The effect of temporal leadership on quiet quitting among primary healthcare workers: The chain-mediating role of time management competency and work-family enrichment and moderating role of organizational communication. Frontiers in Psychology, 16, 1616354. https://doi.org/10.3389/fpsyg.2025.1616354
43. Yasin, Y. M., Al-Hamad, A., Yasin, L., & Kehyayan, V. (2025). Staying but struggling: A concept analysis of quiet quitting in nursing practice. Journal of Advanced Nursing. Advance online publication. https://doi.org/10.1111/jan.70319