Table 1 Study characteristics and findings from included studies

Abd-Ellatif et al. (2021), Egypt

To determine the effect of fear relating to COVID-19 on job satisfaction and turnover intention

Cross-sectional

Physicians (411)

Fear of COVID-19 Scale (FCV-19S), Job satisfaction scale/satisfaction with work scale (SWWS), Turnover intention scale (TIS-6)

Fear of COVID-19 is positively correlated with turnover intention

Job satisfaction is negatively correlated with turnover intention

Fear of COVID-19 may contribute to turnover intention

Job satisfaction may mitigate turnover intention

Alameddine et al. (2021a), Lebanon

To investigate the resilience levels, job satisfaction, and turnover intention of nurses

Cross-sectional

Nurses (265)

Connor-Davidson Resilience Scale (CD-RISC)

Resilience is negatively correlated with turnover intention

Resilience may mitigate turnover intention

Alameddine et al. (2021b), Lebanon

To determine the level of resilience in the nursing workforce and its relationship to burnout, intention to quit, and perceived COVID-19 risk

Cross-sectional

Nurses (511)

Connor-Davidson Resilience Scale (CD-RISC), Copenhagen Burnout Inventory (CBI)

Resilience is negatively correlated with turnover intention

Resilience may mitigate turnover intention

Alameddine et al. (2022), Lebanon

To determine the level of resilience and its relationship to burnout, job satisfaction, intention to quit, and changes in practice

Cross-sectional

Pharmacists (459)

Connor-Davidson Resilience Scale (CD-RISC)

Resilience is negatively correlated with turnover intention

Resilience may mitigate turnover intention

Alenazy et al. (2021), Australia/Saudi Arabia

To examine the relationship between perception of nursing practice environment (NPE), job satisfaction and intention to leave

Cross-sectional

Critical care nurses (152)

Practice Environment Scale of the Nursing Work Index

(PES-NWI), Nursing Workplace Satisfaction Questionnaire

(NWSQ), Turnover Intention Scale (TIS-6)

A positive NPE is negatively correlated with turnover intention

Job satisfaction was not significantly related to turnover intention

Positive working conditions may mitigate turnover intention

Al-Mansour (2021), Saudi Arabia

To investigate the association between stress, social support and turnover intention among healthcare workers

Cross-sectional

Physicians (84)

Nurses (134)

Paramedical workers (84)

Administrative staff (209)

Perceived Stress Scale-10 (PSS-10), Multidimensional Scale of Perceived Social Support (MSPSS)

Stress is positively correlated with turnover intention, with social support acting as a mediating factor

Stress and anxiety may contribute to turnover intention

Social support may mitigate turnover intention

Blake et al. (2020), United Kingdom

To determine the effectiveness of well-being centres on employee well-being

Cross-sectional

Hospital employees (819)

Warwick Edinburgh Mental Well-being Scale (WEMWBS), Utrecht Work Engagement Scale (UWES-9)

There is no significant association between turnover intention and well-being centre access

The relationship between organisational support and turnover intention is inconclusive

Cimarolli et al. (2021), United States of America

To investigate the mediating role of employer communication and staff preparedness on turnover intention

Cross-sectional

Nursing home staff (1,683)

Questionnaires

Higher levels of COVID-19-related challenges are positively correlated with turnover intention

Quality employer communication is indirectly and negatively associated with turnover intention, with job preparedness acting as a mediating factor

Fear of COVID-19 may contribute to turnover intention

Organisational support may mitigate turnover intention

Cole et al. (2021), United States of America

To investigate if anxiety and stress from COVID-19 working conditions contribute to turnover intention

Cross-sectional

Nurses (111)

Questionnaires

Married and senior nurses are more likely to experience turnover intention

Psychological stress and anxiety are positively correlated with turnover intention

Personal demographics may affect turnover intention

Stress and anxiety may contribute to turnover intention

Cornish et al. (2021), Australia

To explore the intentions of emergency nurses to remain in or leave emergency nursing after the first year of the COVID-19 pandemic

Cross-sectional

Emergency nurses (398)

Questionnaires

Nurses who received COVID positive patients were more likely to experience turnover intention

Nurses who did not feel connected to their colleagues, team or organisation were more likely to experience turnover intention

Fear of COVID-19 may contribute to turnover intention

A lack of organisational support and social support may contribute to turnover intention

De los Santos and Labrague (2021), Philippines

To assess the impact of fear of COVID-19 on job stress and turnover intention among community nurses

Cross-sectional

Community nurses (385)

Fear of COVID-19 Scale (FCV-19S),

Job Satisfaction Index (JSI),

Job Stress Scale (JSS)

Fear of COVID-19 is positively correlated with turnover intention

Fear of COVID-19 may contribute to turnover intention

Elhanafy and El Hessewi (2021), Egypt

Effect of fear of COVID-19 pandemic on work satisfaction and turnover intentions of nurses

Cross-sectional

Nurses (210)

Fear of COVID-19 scale (FCV-19S),

Job Satisfaction Index (JSI)

Fear of COVID-19 is positively correlated with turnover intention

Fear of COVID-19 may contribute to turnover intention

Fisher et al. (2021), United States of America

To explore factors that influenced the personal and professional well-being of care providers working in long-term care facilities

Qualitative descriptive

Certified nursing assistants (8)

Nurses (4)

Other (2)

Semi-structured interview

Workplace stressors such as high workloads and low staff morale are associated with turnover intention

Difficult working conditions may contribute to turnover intention

Fronda and Labrague (2022), Oman/Philippines

To examine the relationship between coronaphobia and frontline nurses’ organisational and professional turnover intention, and to assess whether social support and coping skills can buffer this relationship

Cross-sectional

Nurses (687)

Coronavirus Anxiety Scale (CAS), Brief Coping

Skills Scale (BCS), Perceived

Social Support Questionnaire (PSSQ)

Coronaphobia is positively related to turnover intention, with social support and coping skills acting as mediating factors

Fear of COVID-19 may contribute to turnover intention

Social support may mitigate turnover intention

Hou et al. (2021), China

To assess the prevalence of turnover intention and explored associated factors on turnover intention among healthcare workers during the COVID-19 pandemic in China

Cross-sectional

Physicians (845)

Nurses (344)

Others (214)

Depression Anxiety Stress Scale − 21 (DASS-21), Perceived Social Support (PSS) Scale

Workers in secondary hospitals were more likely to experience turnover intention

Workers with daily working hours of more than 12 h were more likely to experience turnover intention

Workers who refused to volunteer for frontline roles were more likely to experience turnover intention

Workers who experienced no change in patient relations were more likely to experience turnover intention

Workers who experienced depression, low social support or a combination of psychosocial issues were more likely to experience turnover intention

Difficult working conditions may contribute to turnover intention

Poor mental health may contribute to turnover intention

Khattak et al. (2021), Pakistan

To explore the moderating effect of leadership support in the relationship between fear of COVID-19, turnover intention and psychological distress in nurses

Cross-sectional

Nurses (380)

Fear of COVID-19 Scale (FCV-19S)

Fear of COVID-19 is positively correlated with turnover intention, with leadership support acting as a mediating factor

Fear of COVID-19 may contribute to turnover intention

Organisational support may mitigate turnover intention

Labrague and de Los Santos (2021a), Oman/Philippines

To examine whether frontline nurses' fear of COVID-19 contributes to psychological distress, work satisfaction and intent to leave their organisation and the profession

Cross-sectional

Nurses (261)

Fear of COVID-19 Scale (FCV-19S),

Job Satisfaction Index (JSI),

Job Stress Scale (JSS)

Fear of COVID-19 is positively correlated with turnover intention

Fear of COVID-19 may contribute to turnover intention

Labrague and de Los Santos (2021b), Oman/Philippines

To examine the mediating role of resilience in the relationship between compassion fatigue and frontline nurses' job outcomes

Cross-sectional

Nurses (270)

Compassion Fatigue Scale (CFS),

Brief Resilient Coping Skills (BRCS) scale

Compassion fatigue is positively correlated with turnover intention, with resilience acting as a mediating factor

Compassion fatigue may contribute to turnover intention

Resilience may mitigate turnover intention

Labrague et al. (2021), Oman/Philippines

To assess the influence of COVID-19-associated discrimination on frontline nurses’ mental health and their intention to quit the nursing profession with resilience acting as a mediator

Cross-sectional

Nurses (259)

COVID-19-Associated Discrimination (CAD) scale, Brief Resilient

Coping Skills (BRCS) scale, Mental Health Inventory (MHI)

COVID-19-associated discrimination is positively correlated with turnover intention, with resilience acting as a mediating factor

COVID-19-associated discrimination may contribute to turnover intention

Resilience may mitigate turnover intention

Lavoie-Tremblay et al. (2021), Canada

To examine the influence of caring for COVID-19 patients on nurse’s perceptions of chronic fatigue, quality of care, satisfaction at work and intention to leave their organisation and the profession

Cross-sectional

Nurses (1705)

Transformational Leadership scale, Occupational Fatigue Exhaustion

Recovery Scale (OFER)

High job demands and poor job resources are positively correlated with turnover intention

Nurses who were infected or had team members who were infected with COVID-19 were more likely to experience turnover intention

Difficult working conditions may contribute to turnover intention

Fear of COVID-19 may contribute to turnover intention

Lotfi et al. (2021), Iran

To determine turnover intention among operating room nurses during the COVID-19 outbreak and its association with perceived safety climate

Cross-sectional

Operating room nurses (190)

Anticipated Turnover Scale (ATS), Safety Climate Scale (SCS)

Perceived safety climate is negatively correlated with turnover intention

A strong safety climate may mitigate turnover intention

Magnavita et al. (2021a), Italy

To measure the perception of organisational justice and occupational stress and how these varied in relation to external factors, such as turnover intention

Cross-sectional

Intensive care physicians (120)

Colquitt questionnaire, Siegrist effort/reward imbalance model questionnaire

Physicians who put in high effort and perceived low rewards from work were more likely to experience turnover intention

Difficult working conditions may contribute to turnover intention

A lack of organisational support may contribute to turnover intention

Magnavita et al. (2021b), Italy

To assess the well-being and mental health of the workers after the first 10 months of the pandemic and to evaluate the extent to which their attitude toward the pandemic had changed

Cross-sectional

Physicians (105)

Nurses (47)

Goldberg Anxiety and Depression Scale (GADS), Sleep Condition Indicator (SCI-02)

Healthcare workers who put in high effort were more likely to experience turnover intention, with perceived rewards from work acting as a mediating factor

Difficult working conditions may contribute to turnover intention

A lack of organisational support may contribute to turnover intention

Majeed et al. (2021), Pakistan

To investigate the mediating role of perceived fear of COVID-19 between perceived risk of COVID-19 and turnover intention

Cross-sectional

Nurses (103)

Paramedical staff (59)

Doctors (16)

Modified Perceived Vulnerability to Disease (PVD) questionnaire, Fear of COVID-19 Scale (FCV-19S)

Perceived risk of COVID-19 is positively correlated with turnover intention, with fear of COVID-19 acting as a mediating factor

Fear of COVID-19 may contribute to turnover intention

Mercado et al. (2022), United States of America

To examine the association between personal, work-related and contextual factors, and stress, burnout and turnover intention among healthcare workers in the COVID-19 pandemic

Cross-sectional

Medical staff (328)

Allied health staff (379)

Administrative staff (224)

Others (36)

Mindful Self-Care Scale, Mental Health Continuum Short Form

(MHC-SF), Healthcare Worker Exposure Response &

Outcomes (HERO) Daily Impact Index, Pandemic Experiences and Perceptions Survey, Perceived Stress Scale (PSS-4)

Age and quality of work–life were negatively correlated with turnover intention

Personal demographics may affect turnover intention

Working conditions may affect turnover intention

Mirzaei et al. (2021), Iran

To evaluate the relationship between turnover intention and job stressors in nurses during the COVID-19 outbreak

Cross-sectional

Nurses (479)

Impact of Event Scale-Revised (IES-R), General Health Questionnaire (GHQ), Turnover Intention Questionnaire, Job Content Questionnaire (JCQ)

Job stressors were positively correlated with turnover intention. Married nurses and male nurses were more likely to experience turnover intention

Social support was negatively correlated with turnover intention

Difficult working conditions may contribute to turnover intention

Personal demographics may affect turnover intention

Social support may mitigate turnover intention

Naja et al. (2021), United Arab Emirates

To examine the conditions and changes in the work environment as well as resilience and its correlates among dieticians during the COVID-19 pandemic

Cross-sectional

Dieticians (371)

Connor–Davidson Resilience Scale (CD-RISC)

Resilience is negatively correlated with turnover intention

Resilience may mitigate turnover intention

Nashwan et al. (2021), Qatar

To compare nurses’ turnover intentions before and during COVID-19

Cross-sectional

Nurses (512)

Turnover Intention Scale (TIS-6)

Nurses were more likely to experience turnover intention during the COVID-19 pandemic as compared to beforehand

Fear of COVID-19 may contribute to turnover intention

Öğütlü et al. (2021), Turkey

To determine the relationship between stress, workload, and support in psychiatrists during the COVID-19 pandemic

Cross-sectional

Psychiatrists (217)

Copenhagen Burnout Inventory (CBI)

Burnout is positively correlated with turnover intention

Burnout may contribute to turnover intention

Özkan Şat et al. (2021), Turkey

To determine the relationship between nurses' exposure to violence and their professional commitment during the COVID-19 pandemic

Cross-sectional

Nurses (263)

Nursing Professional Commitment Scale (NPCS)

Nurses who experienced workplace violence were more likely to experience turnover intention

Nurses who faced an increase in working hours, increase in workload and deployment to other departments were more likely to experience turnover intention

Difficult working conditions may contribute to turnover intention

Pförtner et al. (2021), Germany

To examine the relationship between long-term care managers’ intentions to quit their profession and demands that affect long-term care facilities during the COVID-19 pandemic

Cross-sectional

Long-term care facility managers (833)

Questionnaires

Increased pandemic-specific and general job demands are positively correlated with turnover intention

Difficult working conditions may contribute to turnover intention

Raso et al. (2021), United States of America

To describe the relationships between perceptions of the pandemic impact on nurses' intent to leave their current position and the profession

Cross-sectional

Nurses (5,088)

Questionnaires

Nurses who perceived greater pandemic impact on practice were more likely to experience turnover intention

Difficult working conditions may contribute to turnover intention

Riggan et al. (2021), United States of America

To assess the impact of the COVID-19 pandemic on obstetricians and gynaecologists

Mixed-methods

Obstetricians and gynaecologists (72)

Questionnaires (Likert scales & open-ended questions)

Burnout is associated with turnover intention

Burnout may contribute to turnover intention

Said and El-Shafei (2021), Egypt

To assess occupational stress, job satisfaction, and intent to leave among nurses dealing with suspected COVID-19 patients

Cross-sectional

Nurses (420)

Expanded Nursing Stress Scale (ENSS), Specific COVID-19-Associated Stressors (SCAS), McCloskey/Mueller Satisfaction Scale (MMSS)

Nurses with longer working hours and more night duties per week were more likely to experience turnover intention

Difficult working conditions may contribute to turnover intention

Schug et al. (2022), Germany

To examine the correlation between frequency and associated factors of sick leave and intention to quit among nurses

Cross-sectional

Nurses (757)

Effort-reward imbalance scale

(ERI), PHQ-2 (Patient Health Questionnaire), Generalized Anxiety Disorder 2-item (GAD-2)

Perceived reward levels were negatively correlated with turnover intention

Changing work departments during the pandemic was associated with increased turnover intention

Depression levels were positively correlated with turnover intention

A lack of organisational support may contribute to turnover intention

Difficult working conditions may contribute to turnover intention

High levels of depression may contribute to turnover intention

Shah et al. (2022), Pakistan

To identify the association between job stress state anger, emotional exhaustion and job turnover intention

Cross-sectional

Nurses (318)

Maslach Burnout Inventory-General Survey (MBI)

COVID-19-related job stress, state anger and emotional exhaustion are positively correlated with turnover intention

Burnout may contribute to turnover intention

Sheppard et al. (2021), United States of America

To explore the level of moral distress among nurses

Cross-sectional

Nurses (107)

Measure of Moral Distress for Health Care Professionals (MMD-HP)

Nurses who perceived greater issues with patient safety and quality and work environment were more likely to experience turnover intention

Difficult working conditions may contribute to turnover intention

Sklar et al. (2021), United States of America

To examine the effects of work changes on burnout and subsequent turnover intentions in mental health providers, and how job and personal resources may have buffered the extent to which work changes due to COVID-19 impacted burnout

Cross-sectional

Outpatient mental health providers (93)

Copenhagen Work Burnout Inventory, Modified Michigan Organizational Assessment Questionnaire

Work changes were indirectly positively correlated with turnover intention through burnout, with organisational trust and perceived organisational support acting as mediating factors

Difficult working conditions may contribute to turnover intention

Burnout may contribute to turnover intention

Organisational support may mitigate turnover intention

Varasteh et al. (2021), Iran

To explore the factors affecting nurses’ intentions to leave or stay in their profession during the COVID-19 pandemic

Qualitative descriptive

Nurses (19)

Semi-structured interview

Professional commitment was associated with reduced turnover intention

Fear of COVID-19 was associated with turnover intention

A positive organisational atmosphere and organisational motivation was associated with reduced turnover intention

Professional commitment may mitigate turnover intention

Fear of COVID-19 may contribute to turnover intention

Organisational support may mitigate turnover intention

Wibowo and Paramita (2022), Indonesia

To investigate the impact of mindful and empathetic leadership on resilience and turnover intention, with self-regulation as a mediating variable

Cross-sectional

Nurses (188)

Modified Mindfulness Attention Awareness Scale (MAAS), Motivating Language Scale, Connor-Davidson Resilience Scale (CD-RISC)

Mindful leadership was associated with reduced turnover intention, with self-regulation acting as a mediating factor

Organisational support may mitigate turnover intention

Self-regulation may mitigate turnover intention

Wood et al. (2021), United Kingdom

To understand the experiences of advanced practice nurses during the COVID-19 pandemic in relation to safety, shortages and retention

Mixed-methods

Nurses (124)

Questionnaires (Likert scales & open-ended questions)

PPE shortages and fear of COVID-19 were both associated with turnover intention

Fear of COVID-19 may contribute to turnover intention

Yáñez et al. (2020), Peru

To assess the anxiety, distress, and turnover intention of healthcare workers during the COVID-19 pandemic

Cross-sectional

Hospital technicians (80)

Nurses (63)

Pharmacists (63)

Physicians (53)

Hospital volunteers (20)

Others (24)

Generalized Anxiety Disorder (GAD-7) scale, Kessler Psychological Distress scale (K6)

Younger workers were more likely to experience turnover intention

Personal demographics may affect turnover intention

Yang et al. (2021), China

To elucidate the effects of workplace violence on turnover intention among Chinese health care workers, and to identify the potential mediators in this relationship

Cross-sectional

Doctors, nurses and allied health workers (1,063)

Perceived Social Support (PSS) scale, Depression Anxiety Stress Scales-21 (DASS-21)

Workplace violence was positively correlated with turnover intention, with social support and mental health acting as mediating factors

Difficult working conditions may contribute to turnover intention

Social support may mitigate turnover intention

General stress and anxiety may contribute to turnover intention