The Association Between Job Stress and Intention to Leave in Healthcare Institutions: A Systematic Review and Meta-Analysis

Background: Job stress is a pervasive issue in modern workplaces and is associated with numerous adverse outcomes, including employees’ turnover intention when stress levels are high. Objective: This study aimed to examine the association between job stress and turnover intention among employees working in healthcare institutions through meta-analysis. Methods: A systematic literature review and meta-analysis were performed following PRISMA guidelines. The study was registered in the International Prospective Register of Systematic Reviews (PROSPERO; ID: CRD42024581906). Considering variations in sample sizes, publication years, and measurement scales, a random-effects model was employed. Effect sizes were illustrated with a forest plot, and publication bias analyses were performed. Subgroup analyses were conducted by occupational group, COVID-19 period, and geographic region, while meta-regression tested the moderating effects of publication year. Study quality was assessed using the AXIS tool. Results: Based on predefined inclusion criteria, 38 independent studies were included. Findings revealed a moderate-to-high, positive, and statistically significant relationship (r = 0.441; 95% CI [0.389, 0.490]) between job stress and turnover intention among healthcare workers. Moreover, although between-study heterogeneity was substantial (I2 = 95.5%), the direction and statistical significance of the association remained consistent across different countries and healthcare systems. Conclusions: This meta-analysis demonstrated a statistically significant positive association between job stress and turnover intention among healthcare workers (r = 0.441). Although substantial heterogeneity was observed across studies, the relationship remained consistent across occupational groups, regions, and study contexts. Addressing job stress may therefore play an important role in supporting workforce retention in healthcare organizations.