Professional quality of life, sleep quality, occupational stress, and turnover intention among emergency department nurses: A cross-sectional study
- 1Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- 2Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Abstract
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.
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BibTeX
@article{sarmadi2026professional,
title = {{Professional quality of life, sleep quality, occupational stress, and turnover intention among emergency department nurses: A cross-sectional study}},
author = {Sogand Sarmadi and Neda Sanaie and Fariba Borhani and Akbar Zare-Kaseb and Ali Zeidabadi and Sara Beigzadeh and Haniyeh Ghanbari Nasab},
journal = {PLOS One},
year = {2026},
month = sep,
doi = {10.1371/journal.pone.0357570},
url = {https://doi.org/10.1371/journal.pone.0357570},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Professional quality of life, sleep quality, occupational stress, and turnover intention among emergency department nurses: A cross-sectional study
AU - Sogand Sarmadi
AU - Neda Sanaie
AU - Fariba Borhani
AU - Akbar Zare-Kaseb
AU - Ali Zeidabadi
AU - Sara Beigzadeh
AU - Haniyeh Ghanbari Nasab
PY - 2026
DA - 2026/09/22
JO - PLOS One
DO - 10.1371/journal.pone.0357570
UR - https://doi.org/10.1371/journal.pone.0357570
AB - 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.
SN - 1932-6203
ER -