THE IMPACT OF WORKPLACE VIOLENCE AND OCCUPATIONAL BURNOUT ON NURSES' INTENTION TO STAY IN TERTIARY PUBLIC HOSPITALS: A STUDY BASED ON THE SOR THEORY

Abstract

Nurses play a pivotal role in healthcare systems, yet workforce instability remains a pressing global challenge, particularly in tertiary public hospitals with high workloads and patient volumes. This study examines the impact of workplace violence and occupational burnout on nurses’ intention to stay, guided by the Stimulus–Organism–Response (SOR) framework. A cross-sectional survey was conducted from December 2023 to April 2024 across five tertiary public hospitals in Guangdong Province, China, using stratified sampling. A total of 898 valid questionnaires were collected, and data were analyzed with descriptive statistics, t-tests, ANOVA, Pearson correlations, logistic regression, and structural equation modeling (SEM).Findings show that workplace violence was highly prevalent, with 67.4% of nurses reporting psychological violence, 23.4% physical violence, and 11.8% sexual violence in the past year. Nurses exposed to violence had significantly lower retention scores, with psychological violence exerting the strongest negative effect. Burnout was widespread, affecting more than 70% of participants; emotional exhaustion and depersonalization reduced intention to stay, while reduced personal accomplishment showed a paradoxical positive association. SEM confirmed that workplace violence both directly reduced retention intention (β = –0.13, p < .01) and indirectly did so through burnout (β = –0.56, p < .001), highlighting the mediating role of burnout in the stress–outcome pathway. Theoretically, this study extends SOR and integrates it with Conservation of Resources (COR) theory, refining understanding of how resource depletion and burnout dimensions affect retention. Practically, the findings call for multi-level interventions: hospitals should establish violence-prevention and support systems, policymakers should enforce protective regulations, and nurses should engage in peer support and resilience-building programs. Future research should expand to diverse hospital settings, adopt longitudinal designs, and incorporate organizational and leadership factors to enhance models of nurse retention.