Alarm Fatigue and Turnover Intention Among Haemodialysis Nurses: The Mediating Role of Professional Quality of Life

AIMS: This study examined the relationship between alarm fatigue and turnover intention among dialysis nurses and investigated the mediating role of professional quality of life (ProQOL). DESIGN: An analytical cross-sectional study was conducted. METHODS: This study employed a nonprobability sample of 140 dialysis nurses from hospitals affiliated with Shahid Beheshti University of Medical Sciences in Iran in December 2024. Data for this study were collected via a multi-section survey. This research initially focused on identifying demographic and occupational variables. Section two employed the Alarm Fatigue Questionnaire; section three, the ProQOL scale; and section four, the Turnover Intention Questionnaire. Data analysis was carried out using IBM SPSS Statistics, version 27.0. RESULTS: The mean scores for alarm fatigue and turnover intention were 34.02 (SD = 8.50) and 48.70 (SD = 11.66), respectively. Item-level means for alarm fatigue were 2.62 (SD = 0.65) on a 0-4 scale. Also, scores were 3.30 (SD = 0.81) for secondary traumatic stress (STS), 3.61 (SD = 0.90) for compassion fatigue (CF), 3.01 (SD = 0.78) for compassion satisfaction (CS), and 3.25 (SD = 0.78) for turnover intention on 1-5 Likert-type scales. Pearson's correlation showed that alarm fatigue was positively correlated with STS, CF and turnover intention, and negatively correlated with CS. Multiple linear regression explained 62.9% of the variance in turnover intention; single marital status, CS, CF and STS were significant independent predictors. Path analysis showed a significant total association between alarm fatigue and turnover intention, a non-significant direct association, and a significant indirect association through ProQOL components, a pattern consistent with mediation by ProQOL. CONCLUSIONS: Path analysis showed a pattern of associations consistent with ProQOL mediating the relationship between alarm fatigue and turnover intention. The association between alarm fatigue and turnover intention appeared to operate primarily in association with STS, compassion fatigue, and compassion satisfaction, although the cross-sectional design precludes causal inference. These findings are consistent with the hypothesis that improving ProQOL may be associated with a weaker link between alarm fatigue and turnover intention, though this should be confirmed in longitudinal studies.