Professional quality of life, sleep quality, occupational stress, and turnover intention among emergency department nurses: A cross-sectional study.

BACKGROUND

Emergency department (ED) nurses face a heavy workload and high psychological demands that may adversely affect their professional quality of life (Pro-QoL), sleep patterns, occupational stress, and turnover intention. This study examined the associations between ProQoL, sleep quality, occupational stress, and turnover intention among ED nurses, and identified factors associated with turnover intention.

METHODS

The study, conducted in 2025, employed a descriptive cross-sectional design and included 180 nurses in the ED of university hospitals in Tehran Province. Data were gathered using the Professional Quality of Life Scale (ProQOL), the Pittsburgh Sleep Quality Index (PSQI), the Expanded Nursing Stress Scale (ENSS), and the Turnover Intention Questionnaire. Descriptive statistics, Spearman rank correlation, Mann-Whitney U and Kruskal-Wallis H tests, and robust regression were employed in the data analysis.

RESULTS

The mean score of turnover intention was 49.26. Turnover intention was significantly associated with sleep quality (r = 0.329), job stress (r = 0.408), burnout (r = 0.575), compassion satisfaction (r = -0.555), and secondary traumatic stress (STS) (r = 0.594) (p < 0.01). In the regression analysis, compassion satisfaction, burnout, STS, job stress, financial status, nurse-to-patient ratio, and shift type were significant predictors of turnover intention.

CONCLUSION

These findings suggest that Pro-QoL, occupational stress, financial status, shift scheduling, and nurse-to-patient ratio are significantly associated with turnover intention among ED nurses. Longitudinal research is needed to establish causal pathways and evaluate targeted interventions.