ORIGINAL ARTICLE

Journal of Community Empowerment for Health (JCOEMPH) 2024, Volume 7, Number 1: 47-56
P-ISSN. 2655-0164, E-ISSN: 2654-8283

Impact of job satisfaction and job burnout on

nurses’ turnover intention at X Regional Hospital

Daniyah Fitriyah Puteri1, Rizma Adlia Syakurah2*

ABSTRACT

Introduction: As one of Indonesia’s largest regional government-owned hospitals, Hospital X faces high nursing staff
resignations, with turnover rates surpassing the ideal rate of 4%. Job dissatisfaction and burnout indication contribute to
nurses’ intention to leave. Consequently, this study analyses job satisfaction and burnout on nurses’ turnover intention at X
Regional Hospital.
Methods: A cross-sectional study was conducted between November 14 and December 14, 2022. Data
was obtained through Google Forms and distributed to 293 nurses with a total sampling technique. Data
was analyzed using Structural Equation Modelling (SEM) with the assistance of SmartPLS 4 software.
1
Student of Public Health Science, Results: As many as 274 respondents were declared willing to participate in this study. The job satisfaction has an insignificant
Faculty of Public Health, Universitas negative influence on nurses’ turnover intention. However, job satisfaction has a significant negative relationship with job
Sriwijaya, Indralaya, Indonesia;
burnout, and job burnout has a significant positive effect on nurse turnover intention and a significant adverse effect on job
2
Public Health Sciences, Faculty of Public
Health, Universitas Sriwijaya, Indralaya, satisfaction. Demographic factors also significantly influence nurses’ job satisfaction and job burnout. Then, in the indirect
Indonesia. effect test, job burnout mediates the relationship between job satisfaction and nurses’ intention to leave work. At the same
time, demographics affect nurses’ intention to leave work through their level of job burnout.
*Corresponding author: Conclusion: However, the results indicate no significant influence of job burnout mediated by job satisfaction and
Rizma Adlia Syakurah; demographic factors mediated by job satisfaction on turnover intention. Hence, HR management should support and
Public Health Sciences, Faculty of Public implement proactive measures, including revising the SOP for nurse schedule exchanges. Additionally, counseling programs
Health, Universitas Sriwijaya, Indralaya, should be considered to address low personal achievement issues among nurses.
Indonesia;
rizma.syakurah@gmail.com
Keywords: Demographic; job satisfaction; job burnout; nurse; turnover intention.
Submitted: 2023-08-10 Cite This Article: Puteri, D.F., Syakurah, R.A. 2024. Impact of job satisfaction and job burnout on nurses’ turnover intention at
Revised: 2024-01-03 X Regional Hospital. Journal of Community Empowerment for Health 7(1): 47-56. DOI: 10.22146/jcoemph.87883
Accepted: 2024-01-25

INTRODUCTION to hospital healthcare services.3,4 In general, the presence of turnover

Nurses, being more numerous than intention serves as an early indication of
The fulfillment of health workers in
other health workers, serve as the actual turnover.7
Indonesia should have been achieved;
backbone of healthcare facilities. Their Hospital X commenced its official
however, the issue arises when hospitals
primary role as caregivers involves active operations in June 2018 and was one
face a shortage of nurses due to their
engagement in nursing care to patients of the designated referral hospitals for
uneven distribution throughout the
around the clock.3 The availability of well- COVID-19 and one of Indonesia’s largest
country. According to the Decree of
trained and skilled nursing staff is pivotal regional government-owned hospitals.
the Coordinating Minister for People’s
for the success of hospitals in delivering Unfortunately, this regional hospital
Welfare Number 54 of 2013, concerning
health services, thereby enhancing the experienced a significant number of
the Target Standard for Human Resources
quality of life and satisfaction of healthcare resigned nurses. High nurse turnover rates
for Health (HRH) Requirement Ratio,
recipients. However, various problems and have been observed from 2021 to 2022
the projected ratio for 2025 is 200 nurses
changes in the nursing service system (as of July), amounting to 13 people, with
per 100,000 population.1 However, in
have emerged due to insufficient nurses the turnover rate in 2021 amount 5.7%.
South Sumatra Province, there were
to cater to patient needs.5 Alterations in This surpasses the ideal turnover rate,
16,194 nurses in 2022, of which 30% were
nurses’ working conditions have increased according to Mayawati (2021), which is
deployed in Palembang City.2 This data
turnover intention within healthcare between 3%-6% per year in sectors such as
indicates an insufficiency of nurses in
organizations, influenced by prolonged nursing that are required to provide high
Palembang to serve the entire population
exposure to work-related stress (burnout) service levels.8 This indicates the necessity
adequately. Nursing personnel are crucial
and job dissatisfaction. Turnover intention for the hospital to anticipate, given its
in improving health status and have been
represents a conscious decision to leave the proximity to the ideal turnover rate. A high
regulated by law as essential contributors
organization and has been premeditated.6 turnover rate may suggest that the number

Journalaccess:
Open of Community Empowerment for Health 2024; 7(1): 47-56 | doi: 10.22146/jcoemph.87883
https://jurnal.ugm.ac.id/jcoemph 47
 ORIGINAL ARTICLE

that approximately 50.9% of nurses in

four provinces experienced complaints
related to work stress, inadequate rest,
heavy workloads, frequent fatigue,
time constraints, and insufficient
salaries without adequate incentives.12
Unaddressed work stress among nurses
can lead to job dissatisfaction and
burnout.13 Previous research demonstrated
a significant association between burnout
syndrome and turnover intention.14
This study is crucial due to the
scarcity of prior research exploring the
correlation between job satisfaction,
job burnout, and turnover intention
among nurses in Palembang hospitals. A
decline in nurses’ job satisfaction could
Figure 1. The number of health workers who resigned between 2020 and 2021. potentially impact the quality of patient
care, while structural empowerment
among nurses is closely linked to patient
safety. Hence, this study aims to analyze
the impact of job satisfaction and
burnout on nurses’ turnover intention,
specifically at X Regional Hospital in
South Sumatra Province. The findings
are expected to uncover critical factors
influencing nurses’ turnover intention and
provide recommendations for enhancing
Figure 2. The correlation initial model on the variables. employment quality and healthcare
The hypotheses are as follows: standards.
H1: Job satisfaction has a significant negative effect on turnover intention.
H2: Job burnout has a significant positive effect on turnover intention. METHOD
H3: Job burnout has a negative effect on job satisfaction. This study utilizes a quantitative analytical
H4: Job satisfaction has a negative influence on job burnout. design with a cross-sectional approach. The
H5: Demographic factors influence job satisfaction. study population includes all 293 nurses
H6: Demographic factors influence job burnout. employed at X Regional Hospital in South
H7: Job satisfaction influences turnover intention, mediated by job burnout. Sumatra Province, identified through
H8: Job burnout influences turnover intention, mediated by job satisfaction. questionnaires administered to the Human
H9: Demographic factors influence turnover intention, mediated by job satisfaction. Resources Management staff. The total
H10: Demographic factors influence turnover intention, mediated by job burnout. sampling method was utilized; however,
19 potential respondents expressed their
of nurses departing from the hospital particularly nurses, can be influenced unwillingness to participate in the study,
within a specified timeframe exceeds what by various internal and external factors. resulting in a research sample size of 274
is generally considered normal. Based on Job dissatisfaction is generally the respondents.
the following graph, the turnover rate of most significant factor contributing to The initial model of correlation
nurses is higher than that of other health turnover.7,10,11 Job satisfaction is crucial between variables can be seen in Figure 2.
workers (figure 1) : in all work processes and benefits for Data were collected between
High nurse turnover significantly the hospital. Satisfied nurses are more November 14 and December 14, 2022,
impacts hospital performance by losing productive and consistently deliver high- utilizing an online survey administered
experienced and competent nurses due quality performance, leading to greater via Google Forms and distributed to
to frequent turnover.9 It will necessitate satisfaction among healthcare service the sample. The research instrument
increased allocation of resources for users. used a questionnaire with a Likert Scale
recruiting and training new nurses. If Furthermore, job burnout poses consisting of respondent characteristics
left unresolved, this issue can indirectly another concern for nurses in Indonesia. of job satisfaction using the McCloskey/
affect the quality of patient care. A survey by the Indonesian National Mueller Questionnaire (1990)15, adapted
Turnover among healthcare workers, Nurses Association (PPNI) 2007 revealed to Indonesia’s language16. The job burnout

48 Journal of Community Empowerment for Health 2024; 7(1): 47-56 | doi: 10.22146/jcoemph.87883
 ORIGINAL ARTICLE

Table 1. Question Items of Questionnaire

Variable Question Items Code Item
Demographic (Respondents Age US
Characteristic) Gender JK
Residential Distance JTT
Education Level TP
Employment status SK
Work Period MK
Work Unit UK
Marital Status SP
Job Satisfaction Control and responsibility CR 1, 2, 3, 4, 5
(McCloskey/Mueller) Scheduling (Shifting schedule) SC 6, 7, 8, 9, 10, 11
Interaction Opportunities (Interaction in the work environment) IO 12, 13, 14, 15
Professional Opportunities PO 16, 17, 18, 19
Extrinsic (External rewards) EX 20, 21, 22
Coworkers (Relationship with colleagues) CW 23, 24
Praise and recognition PR 25, 26, 27, 28
Balance of family and work BFW 29, 30, 31
Job Burnout Emotional Exhausted EE 1, 2, 3, 4, 5, 6, 7, 8, 9
(Maslach Burnout Inventory- Depersonalization DP 10, 11, 12, 13, 14
Human Services Survey (MBI-HSS)) 15, 16, 17, 18, 19, 20,
Personal Accomplishment PA
21, 22
Turnover Intention (Turnover Thinking of Quitting TQ 1, 2
Intention Scale) Intention to Leave IL 3, 4
Job Search JS 5, 6

(≥Mean) and “low” (<Mean). Then, the

frequency of turnover intention as a
whole is categorized into three categories,
namely “high” (0-10), “moderate” (11-
20), and “low” (212-30).12 We analyzed
the data descriptively with Ms. Excel
and SPSS 25, and hypothesis testing with
Structural Equation Modelling (SEM)
through SmartPLS 4 application with two
stages of evaluation, namely Outer Model
(Measurement Model) and Inner Model
(Structural Model).
Research ethics issues, including
informed consent, anonymity, and
confidentiality, were handled carefully
during the study. This study was approved
Figure 3. Nurse Distribution Participating at X Regional Hospital. by the Faculty of Public Health Ethics
Committee, Sriwijaya University, Number
questionnaire from Maslach Burnout 75%), and “less” (≤55%).16 The level of 354/UN9.FKM/TU.KKE/2022.
Inventory-Human Services Survey (MBI- job burnout (X2) are divided into three
HSS)17, and turnover intention that has categories for each indicator, namely RESULT
been adapted to Bahasa12,19, which had “mild” (EE = ≤16, D.P. = ≤6, PA = ≥39),
Sample Characteristics
been tested for reliability 0.977, 0.918, “moderate” (EE = 17 – 26, DP = 7 – 12, PA
The majority of nurses were 26-35 years old
0.910 and validity with score 0.544-0.922, = 38 – 32) and “severe” (EE = ≥27, D.P. =
(66.4%), female (76.6%), married (65.7%),
0.305-0.810, 0.762-0.927, respectively. The ≥13, PA = ≤31). Then the overall frequency
residing as far as 2-10 KM (65.7%), with
question items of the questionnaire are of job burnout levels is categorized into
the last educational is D III Nursing,
shown in Table 1. two, namely “not burnout” (0 - 35) and
(42.3%), as contract workers (42.3%), with
The level of job satisfaction (X1) is “burnout” (36 – > 65).18,19 The level of
work period for >3 years (42.3%) (table 2)
divided into three categories, namely turnover intention (Y) is divided into two
and work in the Perinatology unit (13.1%)
“good” (76 – 100%), “enough” (56 – categories, namely the “high” category

Journal of Community Empowerment for Health 2024; 7(1): 47-56 | doi: 10.22146/jcoemph.87883 49
 ORIGINAL ARTICLE

Table 2. Characteristics of Research Informants (Figure 3).

No Characteristics of Respondents n % The majority of respondents fell into
1 Age the “good” category (41.97%) and the
<25 Years 51 18.6 “enough” category (54.74%), implying that
26 – 35 Years 182 66.4 most hold a positive outlook toward job
36 – 45 Years 39 14.2 satisfaction. A significant proportion of
46 – 55 Years 2 0.7 them experienced burnout in their work
2 Gender (81.02%) and exhibited a low intention
Male 64 23.4 to leave their job (72.26%). However, it is
Female 210 76.6 crucial to acknowledge that the reported
3 Marital Status turnover intention rates range from
Married 180 65.7 2.92% to 24.81%. According to Gillies,
Not married 94 34.3 this indicates higher turnover intention
4 Residential Distance
rates among the respondents compared
<2KM 44 16.1
to the standard turnover intention among
hospital nurses, which typically falls
2 – 10KM 124 45.3
within 5% to 10%.7
> 10KM 106 38.7
At the level of job satisfaction, the
5 Education Level
majority of respondents have a good level
Diploma (D III) 180 65.7
of job satisfaction on the IO indicator
Applied Bachelor’s Degree (DIV) 3 1.1
(44.5%) and CR (44.2%) and are quite
Bachelor’s/Ners 86 31.4
satisfied with the BFW and PO indicators
Master of Nursing/Health 5 1.8
(67.5%). Meanwhile, 21.5% of respondents
6 Employment Status
felt dissatisfied with the SC indicator.
Civil servant 105 38.3
Then, at the level of job burnout, the
BLUD Non PNS 53 19.3
majority of respondents have mild job
Contract worker 116 42.3
burnout on the DP indicator (54.6%) and
7 Work Period
moderate job burnout on the EE indicator
< 6 Months 21 7.7 (13.8%). Meanwhile, 10.9% of respondents
6 Months – 1 Year 79 28.8 felt severe job burnout in the PA indicator.
1 – 3 Years 58 21.2 On the other hand, at the level of turnover
>3 Years 116 42.3 intention, the majority of respondents
have low turnover intention in the TQ
Table 3. Respondents’ Job Satisfaction, Job Burnout, and Turnover Intention indicator (88.7%). Meanwhile, 12.4% of
Level respondents have high turnover intention
Job Satisfaction Level on the JS indicator (table 3).
Indicator
Good Enough Less
CR 121 (44.2%) 14 (52.6%) 9 (3.3%) Reflective Model Measurement
SC 72 (26.3%) 143 (52.2%) 59 (21.5%) In the reflective outer model measurement,
IO 122 (44.5%) 149 (54.4%) 3 (1.1%) which is evaluated by testing construct
PO 79 (28.8%) 185 (67.5%) 10 (3.6%) reliability (Composite Reliability and
EX 61 (22.3%) 177 (64.6%) 36 (13.1%) Cronbach’s Alpha), convergent validity
CW 99 (36.1%) 170 (62.0%) 5 (1.8%) (outer loadings and Average Variance
PR 86 (31.4%) 178 (65.0%) 10 (3.6%) Extracted (AVE)), and discriminant
BFW 70 (25.5%) 185 (67.5%) 19 (6.9%) validity (Fornell-Larcker Criterion). The
Job Burnout Level acceptable limit for composite reliability
Indicator
Mild Moderate Severe is the same as any measure of reliability,
EE 177 (43.0%) 57 (13.8%) 40 (9.7%) including Cronbach’s Alpha, with a value
DP 225 (54.6%) 27 (6.6%) 22 (5.3%) >0.7. Then, the expected value to meet
PA 216 (52.4%) 13 (3.2%) 45 (10.9%) convergent validity is >0.7. However,
Turnover Intention Level the value of outer loadings >0.5 can be
Indicator tolerated to maintain this indicator by
High Low
TQ 31 (11.3%) 243 (88.7%) considering the increase in the AVE value
IL 32 (11.7%) 242 (88.3%) and composite reliability. The AVE value
JS 34 (12.4%) 240 (87.6%) is expected to meet the minimum good
criteria, namely >0.5. In discriminant

50 Journal of Community Empowerment for Health 2024; 7(1): 47-56 | doi: 10.22146/jcoemph.87883
 ORIGINAL ARTICLE

Table 4. The Results of Reflective Model Measurement Based on Construct Reliability and Convergent Validity
Outer Cronbach’s Composite
Latent Variable Indicator/item AVE
Loadings Alpha Reliability
Job Satisfaction CR1 (control setting) 0.722 0.503 0.964 0.967
CR2 (career advance) 0.644
CR3 (responsibility) 0.741
CR4 (control conditions) 0.776
CR5 (decision making) 0.759
SC1 (work hours) 0.637
SC2 (schedule flexibility) 0.657
SC4 (weekends off) 0.666
SC5 (flexibility weekends) 0.624
SC6 (weekend pay) 0.674
IO1 (care delivery) 0.704
IO2 (work social contact) 0.684
IO3 (social contact outside) 0.712
IO4 (interact disciplines) 0.711
PO1 (interact faculty) 0.787
PO2 (committee) 0.774
PO3 (research) 0.747
PO4 (publish) 0.728
EX2 (vacation) 0.683
EX3 (benefits) 0.601
CW1 (peers) 0.690
CW2 (physicians) 0.690
PR1 (supervision) 0.748
PR2 (superior recognition) 0.758
PR3 (peer recognition) 0.770
PR4 (feedback) 0.772
BFW1 (part-time) 0.706
BFW2 (maternity leave) 0.658
BFW3 (child care) 0.696
Job Burnout EE1 (I feel emotionally drained from my work) 0.647 0.599 0.947 0.954
EE2 (I feel used up at the end of the workday) 0.616
EE3 (I feel fatigued when I get up in the morning and have to
0.695
face another day on the job)
EE4 (working with people all day is really a strain for me) 0.846
EE5 (I feel burnout from my work) 0849
EE6 (I feel frustrated by my job) 0.860
EE7 (I feel I am working too hard on my job) 0.838
EE8 (working with people directly puts too much stress on me) 0.886
EE9 (I feel like I am at the end of my rope) 0.848
DP1 (I have become more callous toward people since I took
0.744
this job)
DP2 (I worry this job is hardening me emotionally) 0.791
DP3 (I feel I treat some recipients as if they were impersonal
0.752
“object”)
DP4 (I do not really care what happens to some recipients) 0.663
DP5 (I feel recipients blame me for some of their problems) 0.739
Turnover Intention TQ1 (I will be quitting my job for the next year) 0.922 0.795 0.948 0.959
TQ2 (I am thinking about quitting my job) 0.945
IL1 (I will quit my job this year) 0.920
IL2 (I will quit my job but not now) 0879
JS1 (I have applied for another job) 0.872
JS2 (I am actively looking for job vacancies) 0.804

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 ORIGINAL ARTICLE

validity, any latent variable with the square Among all the indicators, ten indicators intention have absorbed information on
root of AVE must be higher than its must be eliminated due to not being able indicators. All latent variables are declared
correlation with other latent variables. to increase the AVE value, namely PA1, to have met the minimum criteria of the
Based on Table 4, all latent variables PA2, PA3, PA4, PA5, PA6, PA7, PA8 are all AVE value (Table 5).
demonstrate high composite reliability <0.5, and indicators EX1 (0.597) and SC3
values: 0.967 for job satisfaction, 0.954 (0.602) (table 4). Formative Model Measurement
for job burnout, and 0.959 for turnover The Average Variance Extracted (AVE) The formative outer model measurement
intention. The Cronbach’s Alpha values value in the reflective model has shown was evaluated using Outer Weights and
also indicate high reliability: 0.964 for that all latent variables have a value of > Collinearity Statistics with Variance
job satisfaction, 0.947 for job burnout, 0.5, which means that 50.3% of the latent Inflation Factor (VIF). VIF ≥5 indicates a
and 0.948 for turnover intention. Thus, variables of job satisfaction, 59.9% of likelihood of critical collinearity problems,
all latent variables are considered reliable the latent variables of Job Burnout, and VIF = 3–5 suggests collinearity problems
based on both tests. 79.5% of the latent variables of turnover that are usually not critical, and VIF <3
indicates no collinearity issues.
Table 5. Discriminant Validity Based on Fornell-Larcker Valid indicators (SK, TP, UK, and US)
Job Burnout Job satisfaction Turnover Intention had p-values <0.5, while the others were
Variable removed due to insignificant after re-
(√AVE ) (√AVE ) (√AVE )
x x x
evaluating the outer loadings. VIF values
Job Burnout 0.774 for demographic latent variable indicators
Job satisfaction -0.323 0.709 were below the critical range (VIF <5 or
VIF <3), indicating no collinearity issues
Turnover Intention 0.445 -0.176 0892
(table 6).

Table 6. Demographic Construct Evaluation Based on Outer Weights and VIF

P-Values Beginning Information Outer Loading Information Final P-Values VIF
JK → Demographics 0.414 Invalid 0.365 Not fulfilled -
JTT→Demographics 0.400 Invalid 0.089 Not fulfilled -
MK→Demographics 0.108 Invalid 0.096 Not fulfilled -
SK→Demographics 0.018 Valid - - 0.004 1.115
SP →Demographics 0.319 Invalid 0.187 Not fulfilled -
TP →Demographics 0.018 Valid - - 0.011 1.073
UK→Demographics 0.006 Valid - - 0.003 1.044
US→Demographics 0.008 Valid - - 0.005 1.066

Table 7. Evaluation Inner Model Based on Path Coefficients

Standard
Original Sample T Statistics P
Hypothesis Deviations Accepted
Sample(O) Means(M) (|O/STDEV|) Values
(STDEV)
H1 Job Satisfaction → Turnover Intention -0.036 -0.043 0.065 0.548 0.292 No
H2 Job Burnout→ Turnover Intention 0.434 0.433 0.087 4,973 0.000 Yes
H3 Job Burnout→ Job Satisfaction -0.314 -0.323 0.069 4,578 0.000 Yes
H4 Job Satisfaction → Job Burnout -0.293 -0.299 0.067 4,371 0.000 Yes
H5 Demographics → Job Satisfaction 0.128 0.149 0.075 1,704 0.044 Yes
H6 Demographics → Job Burnout -0.240 -0.248 0.066 3,627 0.000 Yes

Table 8. Evaluation of Inner Model Based on Specific Indirect Effects

Original Sample Standard T Statistics
P
Hypothesis Sample Means Deviations (|O/ Accepted
Values
(O) (M) (STDEV) STDEV|)
H7 Job Satisfaction → Job Burnout →
-0.127 -0.128 0.032 3,962 0.000 Yes
Turnover Intention
H8 Job Burnout→ Job Satisfaction→ 0.013 0.018 0.023 0.563 0.287
No
Turnover Intention
H9 Demographics → Job Satisfaction →
-0.005 -0.007 0.012 0.394 0.347 No
Turnover Intention
H10 Demographics → Job Burnout → -0.104 -0.108 0.039 2,669 0.004
Yes
Turnover Intention

52 Journal of Community Empowerment for Health 2024; 7(1): 47-56 | doi: 10.22146/jcoemph.87883
 ORIGINAL ARTICLE

Table 9. Model Based Quality Evaluation F-Square intention (P-Values = 0.004, t = 2.669).
F-Square Information Structural Equation Modeling
Demographics → Job Burnout 0.084 Small (SEM) cannot analyze in two directions
Demographics → Job satisfaction 0.017 Small simultaneously. Therefore, in this study,
Job Burnout→ Job Satisfaction 0.102 Small two analyses were conducted with the aim
Job Burnout→ Turnover Intention 0.208 Moderate of fulfilling the conceptual framework and
Job Satisfaction → Job Burnout 0.101 Small examining the hypothesis, specifically the
Job Satisfaction → Turnover Intention 0.002 Small influence between job satisfaction and job
burnout variables.
Furthermore, the structural model
is tested by examining the goodness of
fit test results based on the coefficient
of determination R2. The R2 values for
job burnout, satisfaction, and turnover
intention are 0.161, 0.016, and 0.200,
respectively. This indicates that 16% of the
variance in job burnout is explained by the
independent variables (demographic and
job satisfaction variables). In comparison,
only 1% of the variance in job satisfaction
is explained by the independent variables
(demographic and job burnout variables).
Furthermore, 20% of the variance is
explained by the independent variables
(demographic variables, job satisfaction,
and job burnout) for turnover intention.
The results of Effect Size (F-Square)
indicate that demography has a negligible
Figure 4. The Structural Equation Modeling (SEM) of job satisfaction and job burnout effect on job burnout (0.084), a small
variables effect on job satisfaction (0.017), and a
negligible effect on turnover intention
Inner Model Evaluation (Structural Specific Indirect Effects (Analysis of (0.002). Additionally, job burnout has a
Model Test) Indirect Influence of Mediation Variables) negligible effect on job satisfaction (0.102),
Table 7 shows the results of the path Table 8 shows the inner model evaluation’s and job satisfaction has a negligible effect
coefficients analysis for the inner model specific indirect effects analysis results. The on turnover intention (0.002). However,
evaluation. The significance values of the significance values of the path coefficients, job burnout moderately affects turnover
path coefficients confirm the hypotheses indicating the indirect influence between intention (0.208) (table 9).
(hypothesis 1 to hypothesis 6), where variables through the mediating variable, The Q-square result is considered
significance is determined by a T statistic align with hypotheses 7 to 10. The to assess the goodness of fit. A higher
> 1.96 or p-values < 0.05. significance threshold remains the same Q-square value indicates a better model fit
The evaluation based on path for the path coefficients analysis: T statistic with the data. Using the formula: Q2 = 1
coefficients shows that job satisfaction has > 1.96 or p-values < 0.05. – (1 – R12)(1 – R22)(1 – R32), the Q2 have
no significant effect on turnover intention Based on the evaluation of the inner the result is 0.064 (Q2> 0). It can be stated
(p-values = 0.292, t = 0.548). In contrast, model using specific indirect effects, it that the model of the influence of job
job burnout significantly and positively was found that the job burnout variable satisfaction and job burnout is relevant for
influences turnover intention (p-values significantly mediates the effect between the prediction of turnover intention. The
= 0.000, t = 4.973) and job satisfaction job satisfaction and turnover intention goodness of fit is 0.090 (SRMR = 0.090 <
(p-values = 0.000, t = 4.578). Additionally, (P-Values = 0.000, t = 3.962). However, 0.1), which means that the model is fit and
job satisfaction significantly positively job satisfaction does not significantly has a good fit.
impacts job burnout (p-values = 0.000, t = mediate the effect between job burnout
4.371). Moreover, demographic variables and turnover intention (P-Values = 0.287, DISCUSSION
significantly affect job satisfaction t = 0.563) and between demography and
The study found that nurses were
(p-values = 0.044, t = 1.704) and job turnover intention (P-Values = 0.347, t =
dissatisfied with scheduling, in line with
burnout (p-values = 0.000, t = 3.627). 0.394). On the other hand, the job burnout
earlier research.20,21 Indonesia’s nurse
variable significantly mediates the effect
scheduling, largely manual and based on
between demography and turnover
experience, is seen as inefficient and prone

Journal of Community Empowerment for Health 2024; 7(1): 47-56 | doi: 10.22146/jcoemph.87883 53
 ORIGINAL ARTICLE

to causing conflicts due to subjective Managing job-related tiredness is crucial and HR management to reduce burnout
preferences.22,23 Unlike some countries,25 to boosting job satisfaction and combat and dissatisfaction, ultimately lowering
Indonesia lacks state laws regulating feelings of low accomplishment. High turnover intention.
nurses’ working time and breaks. Despite workload and constant readiness in This study found no correlation
similar working hours, considering nurse- nursing can lead to burnout and reduced between demographic factors and turnover
to-patient ratios in scheduling is crucial to satisfaction. Different work schedules can intention via job satisfaction, contrary to
prevent excessive workload.26–29 Overall, affect nurses’ fatigue levels.41 previous studies that linked age, marital
effective scheduling is crucial for boosting Demographic factors like age, status, and service length.50 More research
nurses’ job satisfaction.30–32 education, work unit, and employment is needed to retain nurses, especially
Severe job burnout makes nurses feel status affect job satisfaction among early in their careers, considering their
incompetent and affects their motivation nurses. According to the previous study, perspectives. Gender, education, and work
and productivity.33 It influences their early adulthood groups (26-35 years attributes, including job position, clinical
desire to leave their jobs, reflected old) tend to be satisfied with their jobs.42 experience, and work unit, affect job
in high Job Search scores. Turnover Employees’ age affects job happiness, and satisfaction and job switching (turnover
intention, influenced by job satisfaction higher qualifications often mean higher intention).51
and ease of finding new job prospects, is job satisfaction, possibly due to better pay. Most nurses reported high job
affected by business activity and available A prior study found that higher-educated satisfaction despite dissatisfaction with
opportunities.11 Job satisfaction indirectly nurses are happier at work.43 Factors like work schedules, which did not affect their
impacts turnover intention, contrary to staffing, patient workload, stress, and work resignation. The study found that job stress
some earlier studies that suggest the need environment influence job satisfaction and caused burnout in younger, contract-
for a mediating variable.6,7,34 burnout among nurses.44 Positive practice employed nurses with diplomas, leading to
Job satisfaction has a limited impact environments boost inpatient nurses’ job dissatisfaction and turnover.52,39 The study
on turnover intention, as employees opt happiness.43 stresses that demographics, job stress,
to remain in their current roles due to the Moreover, the higher the level of work environment, and job satisfaction
challenges in securing new ones.35 This demographics (age, employment status, affect nurses’ propensity to leave hospitals,
aligns with previous research indicating education level, and work unit) and supporting prior research on burnout and
that job satisfaction is influenced the lower the job burnout levels in this turnover.53–55,39
by personal life and family, factors study were consistent with previous Despite its valuable implications, the
contributing to decisions regarding job research.45,39,19 Burnout moderated the study’s limitations include incomplete
dissatisfaction and quitting.36 Employees relationship between job satisfaction questionnaire distribution (through the
may prioritize factors in their work and turnover intention, suggesting that Head of the Room), leading to a 93.5%
environment over job satisfaction.37 lower job satisfaction and high burnout target sample reach, and prolonged data
Job burnout significantly and positively contribute to increasing turnover collection. Additionally, biased data may
affects turnover intention, signaling intention.38,14 Poor job recognition, long arise due to many questionnaire items and
that higher burnout increases turnover hours, a difficult task, low personal values, nurses’ busy schedules, as responses are
intention. Job fatigue directly affects and poor organizational management all not directly monitored.
turnover intention in this study, supporting contribute to turnover intention.46 Work
earlier findings.38,39 Burnout is one of the schedule dissatisfaction may also cause CONCLUSION
main reasons people consider quitting nurses to explore other possibilities
This study found that nurses’ job
their professions, as higher burnout Job burnout significantly influences
satisfaction in X Regional Hospital
indicators increase turnover intention.14,39 turnover intention, mediated by job
in South Sumatra Province did not
This study attributes severe job burnout satisfaction. However, in this study, job
significantly affect nurses’ turnover
to personal achievement. Job search satisfaction does not significantly mediate
intention. However, job satisfaction is
(JS) is one of three indications of high the relationship between job burnout and
related to nurses’ job burnout, and the
turnover intention, revealing that nurses turnover intention, which contrasts with
relationship is negative. In other words,
at X Regional Hospital, South Sumatra previous research.47,48 Burnout, resulting
the higher the level of job satisfaction, the
Province, feel burnout about themselves, from physical and mental exhaustion,
lower the level of job burnout, and vice
life, and work. These signs suggest that impacts job satisfaction, performance,
versa. Job burnout also had a significant
nurses may contemplate leaving their jobs and turnover intention.14 Conversely,
positive impact on nurses’ turnover
and applying elsewhere. increased job burnout among nurses
intention and a significant negative impact
As job burnout increases, job leads to decreased job satisfaction,
on nurses’ job satisfaction.
satisfaction decreases, and this relationship increasing turnover intention.49 A positive
Research indicates that demographic
is evident among Indonesian hospital work environment helps nurses remain
factors in nurses can influence how
nurses.38,40 Personal accomplishment satisfied despite dissatisfaction with work
satisfied or fatigued they are at work.
contributes most to burnout, while schedules. Addressing these issues requires
When considering nurses’ desire to
scheduling is the least satisfying aspect. support from colleagues, supervisors,
move, job burnout became a factor

54 Journal of Community Empowerment for Health 2024; 7(1): 47-56 | doi: 10.22146/jcoemph.87883
 ORIGINAL ARTICLE

that mediated the relationship between 6. Mahdi AF, Zin MZM, Nor MRM, et al. The 22. Rizany I, Hariyati RTS, Afifah E, et al. The
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