# Burnout and turnover intention in primary public health workers: the mediating role of job satisfaction

## TL;DR

This study explores how burnout and job satisfaction affect the likelihood of primary health workers wanting to leave their jobs, using data from China's Huaihai Economic Zone.

## Contribution

The study identifies job satisfaction as a partial mediator between burnout and turnover intention in primary public health workers.

## Key findings

- Burnout is strongly linked to higher turnover intention and lower job satisfaction.
- Job satisfaction partially mediates the relationship between burnout and turnover intention.
- Multi-level strategies are needed to reduce burnout and retain public health workers.

## Abstract

With increasing attention to primary health care across countries worldwide, primary public health workers are being assigned expanding responsibilities, resulting in heightened workloads and psychological strain. This has contributed to widespread burnout and heightened turnover risk.

Guided by the Job Demands-Resources (JD-R) model, this study aimed to observe turnover intention among primary public health workers and explore the interrelationships between burnout, job satisfaction, and turnover intention.

A cross-sectional survey was conducted among 6,725 primary public health workers in the Huaihai Economic Zone in China to assess their levels of burnout, job satisfaction, and turnover intention. One-way ANOVA was used to examine group differences, stepwise multiple linear regression identified influencing factors, and structural equation modeling (AMOS) test the mediating role of job satisfaction.

Burnout was negatively associated with job satisfaction (r = −0.557) and positively with turnover intention (r = 0.475, both p < 0.001), while job satisfaction was inversely related to turnover intention (r = −0.429, p < 0.001). Regression analysis identified burnout (β = 0.337, p < 0.001) and job satisfaction (β = −0.239, p < 0.001) as key predictors of turnover intention. Structural equation modeling further indicated that job satisfaction partially mediated the link between burnout and turnover intention (indirect effect = 0.089, 95% CI: 0.066–0.112), explaining 22% of the total effect.

The study revealed that burnout influences turnover intention both directly and indirectly, with job satisfaction serving as a key psychological pathway. Addressing burnout requires multi-level strategies—enhancing individual motivation, strengthening organizational support, and advancing institutional reforms—to mitigate psychological strain and sustain the stability of the primary public health workforce.