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. 2025 Feb 13;24(1):166.
doi: 10.1186/s12912-025-02801-x.

Turnover intention among nurses in Iranian hospitals: a systematic review and meta-analysis

Alireza Hajizadeh  1 , Edris Kakemam  2 , Morteza Arab-Zozani  3 , Zahra Najafpoor  4 , Hossein Dargahi  1 , Jalal Saeidpour  5
Affiliations

Turnover intention among nurses in Iranian hospitals: a systematic review and meta-analysis

Alireza Hajizadeh et al. BMC Nurs. .

Abstract

Background: The turnover intention of nurses from their current positions have become a critical global public health challenge. In Iran, as a country facing with several of healthcare challenges, understanding the rate of nurses' turnover intention is of paramount importance. This study aimed to determine the pooled proportion of turnover intention among Iranian hospital nurses through systematic review and meta-analysis.

Methods: This systematic review and meta-analysis adhered to PRISMA guidelines. Relevant studies were identified through a comprehensive search of English and Persian databases, including Web of Science, PubMed, Scopus, Science Information Database, IranMedex, and Magiran from January 2000 to November 2024. The Joanna Briggs Institute checklist was employed to assess the methodological quality of included studies. Pooled mean and standard error with 95% CI were calculated using a random effect model. Data analysis was performed using Comprehensive Meta-Analysis software, with the I² statistic used to evaluate heterogeneity among studies and Egger's test and visual inspection of funnel plots used to investigate the publication bias.

Results: Overall, 42 studies were included in this systematic review and meta-analysis. In total, 12,898 nurses participated in the 42 included studies. The overall turnover intention was 2.96 ± 0.056 (95% CI: 2.85-3.07, P = 0.001). Based on subgroup analysis, the turnover intention was 2.95 ± 0.123 and 2.96 ± 0.064 before and after the implementing of health transformation plan (HTP). Also, subgroup analysis by COVID-19 pandemic showed that the turnover intention was 2.97 ± 0.072 and 2.94 ± 0.095 after and before COVID-19 pandemic, respectively. Based on visual inspection of the funnel plot, and egger's test (2.04 ± 2.96, p = 0.45), no evidence of publication bias was observed.

Conclusion: Nurses turnover intention in Iran are at a moderate level, in general and, before and after the implementation of the HTP and the COVID-19 pandemic. These results support the need to formulate evidence-based policies and plans to enhance nurse retention, contributing to the overall stability of the Iranian health system.

Keywords: Intention; Intention to leave; Meta-analysis; Nurses; Nursing; Personnel turnover; Systematic review.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was approved by the Research Ethics Committee of Tehran University of Medical Sciences (ID: IR.TUMS.SPH.REC.1403.169). Consent for publication: Not applicable. Competing interests: The authors declare no competing interests. Clinical trial number: Not applicable.

Figures

Fig. 1
Fig. 1
PRISMA Flow Diagram
Fig. 2
Fig. 2
Forest plot of pooled mean of turnover intention
Fig. 3
Fig. 3
Funnel plot of the included studies for investigating the publication bias
See this image and copyright information in PMC

References

    1. Esfahani P, Mosadeghrad AM, Akbarisari A. The success of strategic planning in health care organizations of Iran. Int J Health Care Qual Assur. 2018;31(6):563–74. - PubMed
    1. Mosadeghrad A, Ebneshahidi A, Abdolmohammadi A. The impact of strategic planning on job satisfaction among hospital staff: a case study. Health Based Res. 2017;3(2):240–50.
    1. Esfahani P, Afshin M. Job motivation among Iranian nurses; a systematic review and metaanalysis study. Health Res J. 2019;4(1):30–7.
    1. Kakemam E, Albelbeisi AH, Rouzbahani M, Gharakhani M, Zahedi H, Taheri R. Nurses’ perceptions of patient safety competency: a cross-sectional study of relationships with occurrence and reporting of adverse events. PLoS ONE. 2024;19(1):e0297185. - PMC - PubMed
    1. Azizi h. Alazemani f, Ahmadi y. Importance of monitoring the health of patients by nurses and their impact on the quality of nursing care services to the patient. Q J Nersing Manage. 2020;9(1):76–84.

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