Abstract
Purpose: Given nurses’ high turnover and its impact on patient safety and quality of care (Wu et al., 2023), reducing their turnover intention is crucial. This study aimed to (a) test the direct effect of role ambiguity on turnover intention, (b) examine the indirect effect via burnout, and (c) investigate whether physician–nurse collaboration moderates the path from role ambiguity to burnout and, consequently, the conditional indirect effect (moderated mediation) on turnover intention.
Design/Methods: This descriptive, correlational study analyzed data from 507 registered nurses in South Korea collected between October and December 2024. Eligible participants had at least one year of experience in their current unit. We tested direct and indirect effects using the Process macro for SPSS with 10,000 bootstrap resamples, adjusting for age, work unit, and unit tenure. Prior to commencing the study, Institutional Review Board approval was obtained.
Results: Greater role ambiguity was associated with higher burnout (b = 5.817, p < .001) and higher turnover intention (b = 0.158, p < 0.001). Burnout was also positively related to turnover intention (b = 0.021, p < .001). The mediating effect of burnout on the relationship between role ambiguity and turnover intention was significant (b = 0.123, 95% confidence interval (CI) [0.080, 0.173]). Physician-nurse collaboration moderated both the direct effect (interaction b = −0.130, p = .016) and the indirect effect (index of moderated mediation = −0.003, 95% CI [ −0.005, −0.001]), indicating that the greater physician-nurse collaboration mitigates the positive association between role ambiguity and turnover intention through burnout.
Implications: Role ambiguity heightens nurses’ turnover intention by increasing burnout, particularly when physician-nurse collaboration is insufficient. Clarifying nurses’ roles and fostering interprofessional collaboration may reduce burnout and turnover intention. Based on our findings, we recommend regular organizational education on nursing objectives and responsibilities (Cengiz et al., 2021) and managerial communication that provides clear and timely guidance (Dodanwala et al., 2023). Fostering an inclusive organizational culture that supports open communication (Ghattas & Abdou, 2025) and providing interprofessional team training (McLaney et al., 2022) can further strengthen collaboration. Such efforts may help reduce nurses’ burnout and stabilize the nursing workforce.
Notes
References:
Cengiz, A., Yoder, L. H., & Danesh, V. (2021). A concept analysis of role ambiguity experienced by hospital nurses providing bedside nursing care. Nursing & Health Sciences, 23(4), 807–817. https://doi.org/10.1111/nhs.12888
Dodanwala, T. C., Santoso, D. S., & Yukongdi, V. (2022). Examining work role stressors, job satisfaction, job stress, and turnover intention of Sri Lanka’s construction industry. International Journal of Construction Management, 23(15), 2583–2592. https://doi.org/10.1080/15623599.2022.2080931
Ghattas, A. H. S., & Abdou, H. A. (2025). Challenges and best practices for moving forward in interprofessional collaboration in critical care units: Nurses' perspectives. BMC Nursing, 24(1), 317. https://doi.org/10.1186/s12912-025-02860-0
McLaney, E., Morassaei, S., Hughes, L., Davies, R., Campbell, M., & Di Prospero, L. (2022). A framework for interprofessional team collaboration in a hospital setting: Advancing team competencies and behaviours. Healthcare Management Forum, 35(2), 112–117. https://doi.org/10.1177/08404704211063584
Wu, F., Lao, Y., Feng, Y., Zhu, J., Zhang, Y., & Li, L. (2024). Worldwide prevalence and associated factors of nursing staff turnover: A systematic review and meta-analysis. Nursing Open, 11(1), e2097. https://doi.org/10.1002/nop2.2097
Sigma Membership
Non-member
Lead Author Affiliation
Yonsei University, Seoul, South Korea
Type
Poster
Format Type
Text-based Document
Study Design/Type
Descriptive/Correlational
Research Approach
Quantitative Research
Keywords:
Interprofessional and Interdisciplinary, Workforce, Competence, Role Ambiguity, Role Conflict, Personnel Turnover, Intention
Recommended Citation
Lim, Heejin and Lee, Seung Eun, "Effect of Role Ambiguity on Turnover Intention: A Moderated Mediation Model" (2026). International Nursing Research Congress (INRC). 19.
https://www.sigmarepository.org/inrc/2026/posters_2026/19
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-07-23
Effect of Role Ambiguity on Turnover Intention: A Moderated Mediation Model
Toronto, Ontario, Canada
Purpose: Given nurses’ high turnover and its impact on patient safety and quality of care (Wu et al., 2023), reducing their turnover intention is crucial. This study aimed to (a) test the direct effect of role ambiguity on turnover intention, (b) examine the indirect effect via burnout, and (c) investigate whether physician–nurse collaboration moderates the path from role ambiguity to burnout and, consequently, the conditional indirect effect (moderated mediation) on turnover intention.
Design/Methods: This descriptive, correlational study analyzed data from 507 registered nurses in South Korea collected between October and December 2024. Eligible participants had at least one year of experience in their current unit. We tested direct and indirect effects using the Process macro for SPSS with 10,000 bootstrap resamples, adjusting for age, work unit, and unit tenure. Prior to commencing the study, Institutional Review Board approval was obtained.
Results: Greater role ambiguity was associated with higher burnout (b = 5.817, p < .001) and higher turnover intention (b = 0.158, p < 0.001). Burnout was also positively related to turnover intention (b = 0.021, p < .001). The mediating effect of burnout on the relationship between role ambiguity and turnover intention was significant (b = 0.123, 95% confidence interval (CI) [0.080, 0.173]). Physician-nurse collaboration moderated both the direct effect (interaction b = −0.130, p = .016) and the indirect effect (index of moderated mediation = −0.003, 95% CI [ −0.005, −0.001]), indicating that the greater physician-nurse collaboration mitigates the positive association between role ambiguity and turnover intention through burnout.
Implications: Role ambiguity heightens nurses’ turnover intention by increasing burnout, particularly when physician-nurse collaboration is insufficient. Clarifying nurses’ roles and fostering interprofessional collaboration may reduce burnout and turnover intention. Based on our findings, we recommend regular organizational education on nursing objectives and responsibilities (Cengiz et al., 2021) and managerial communication that provides clear and timely guidance (Dodanwala et al., 2023). Fostering an inclusive organizational culture that supports open communication (Ghattas & Abdou, 2025) and providing interprofessional team training (McLaney et al., 2022) can further strengthen collaboration. Such efforts may help reduce nurses’ burnout and stabilize the nursing workforce.
Description
Our cross-sectional study of 507 nurses revealed that role ambiguity increases turnover intention via heightening burnout. In this relationship, physician-nurse collaboration can buffer the positive effect of role ambiguity on burnout as well as turnover intention. These findings indicate that organizational efforts on clarifying professional roles and building collaborative relationships are necessary to reduce nurses’ burnout and secure the nursing workforce.