The Effects of Nurses' Job Stress and Presenteeism on Turnover Intention: Moderated Mediating Effect of Nursing Work Environment

Purpose: This study examined the mediating effect of job stress-related presenteeism and the moderated mediating effect of the nursing work environment on the relationship between job stress and nurses’ turnover intention. Methods: A predictive correlational research design was employed from September 8 to September 26, 2023, involving 176 nurses working in general and tertiary hospitals nationwide. Data were analyzed using IBM SPSS Statistics version 25.0, the PROCESS macro version 4.2, and the EasyFlow Statistics macro version 1.8. Results: The mean scores were 2.76±0.38 for job stress, 3.11±0.81 for job stress-related presenteeism, 2.47±0.50 for nursing work environment, and 3.57±0.75 for turnover intention. Job stress was positively associated with turnover intention through job stress-related presenteeism (B=1.32, p<.001), and the nursing work environment significantly moderated this partial mediating effect (B=0.31; 95% CI, 0.04~0.53). Conclusion: These findings may inform the development of strategies and policies aimed at reducing nurses’ turnover intention and improving human resource management in clinical settings. In addition, this study contributes to the growing body of research on job stress, job stress-related presenteeism, nursing work environment, and turnover intention among nurses.