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. 2025 Mar;81(3):1286-1299.
doi: 10.1111/jan.16290. Epub 2024 Jun 21.

Psychological distress symptoms in nurses and their intention to leave: A cross-sectional secondary data analysis

Hephzibah Sophie Edwin  1 , Alison M Trinkoff  1 , Mary Etta Mills  1 , Shijun Zhu  1
Affiliations

Psychological distress symptoms in nurses and their intention to leave: A cross-sectional secondary data analysis

Hephzibah Sophie Edwin et al. J Adv Nurs. 2025 Mar.

Abstract

Aim: This study aimed to examine the psychological symptoms of distress among nurses in relation to their intention to leave.

Design: This study was a secondary data analysis of a cross-sectional survey collected between November 2020 and March 2021.

Methods: Chi-square was used to examine the associations between the demographic characteristics and intention to leave and psychological distress symptoms-feeling depressed, anxious and worried. Multiple linear regression analyses were performed to examine if work settings, position (staff, charge, administrators, educators/researchers and advanced practice registered nurses) and years of experience were associated with psychological distress and intention to leave. A mediation analysis examined if psychological distress mediated the relationship between years of experience and intention to leave.

Results: Overall, psychological distress was significantly positively associated with intention to leave and negatively associated with years of experience. Nurses with less than 2 years of experience had increased psychological distress, while nurses with >25 years of experience had decreased psychological distress. Both groups of nurses had increased intention to leave compared to those with 16-25 years of experience. Psychological distress partially mediated intention to leave in nurses with less than 2 years of experience and more so among nurses with >25 years of experience.

Conclusions: This study suggests that nurses encounter psychological distress symptoms, such as feeling anxious, depressed and worried, that contribute to an increased intention to leave. Among the workplace locations, nurses practicing in nursing homes had the highest intention to leave.

Impact: The study emphasizes that organizations need to focus on mitigating distress across all levels of nurses to promote retention efforts and intention to stay.

Reporting method: The authors adhered to the STROBE guidelines.

Patient or public contribution: No patient contribution. Completion of the survey in the original study (NWWS) implied consent from the participating nurses.

Keywords: distress; emotional distress; intent to leave; nurses; psychological distress; retention; turnover.

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