Document Type : Review Article
Authors
1
School of Industrial Engineering, Iran University of Science and Technology, Tehran, Iran
2
Mahabad School of Nursing, Urmia University of Medical Sciences
10.34172/jhad.1232
Abstract
Introduction: Turnover among healthcare staff represents a persistent global challenge with substantial consequences for workforce stability, quality of care, and organizational performance. Understanding the multidimensional factors contributing to turnover is essential for developing effective retention strategies, particularly in healthcare systems facing increasing demand and resource constraints. This review aimed to map and categorize the range of factors associated with turnover and turnover intention among healthcare staff and to identify key thematic patterns in the existing literature.
Methods: A structured literature search was conducted across four major international databases (PubMed, Web of Science, Scopus, and Science Direct) for studies published between 2020 and 2025, using predefined keywords and Boolean operators. The review was conducted and reported in line with PRISMA principles. After de-duplication, records were screened at the title, abstract, and full-text levels using predefined eligibility criteria. All eligible studies (n = 129) contributed to descriptive mapping; a core subset (n = 30) was prioritized for in-depth thematic analysis. A thematic approach was used to capture recurring patterns and relationships across studies.
Results: The thematic mapping of the evidence suggested four overarching domains associated with turnover and turnover intention: individual factors, job and organizational factors, managerial and leadership factors, and external or social factors. Prominent challenges included workload and staffing shortages, burnout and job stress, inadequate managerial support, limited career development opportunities, and work–life imbalance. While individual characteristics played a role, organizational and managerial determinants emerged as the most consistently reported contributors to turnover across diverse healthcare settings.
Conclusion: Turnover among healthcare staff is a multifactorial issue, predominantly driven by modifiable organizational and leadership factors. Addressing these determinants through supportive management practices, improved working conditions, and targeted retention policies may substantially reduce turnover and strengthen workforce sustainability. The findings provide a comprehensive evidence base to inform future research and policy interventions in healthcare workforce management.
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