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Turnover Intention Among Nurses and Midwives in Obstetrics Departments: A Nationwide Cross-Sectional Survey in Japan

Year: 2026

Type: article

Abstract: Objective Nurse turnover is a global challenge, and working conditions have been identified as a major contributing factor. Obstetrics departments, in particular, are characterized by high workload intensity due to deliveries and emergency care; however, nationwide evidence on turnover intention among nurses and midwives working in this setting remains limited. This study aimed to examine the correlates of turnover intention among nurses and midwives working in obstetrics departments in Japan and to identify associated individual and organizational factors. Methods A nationwide web-based questionnaire survey was conducted among nurses and midwives working in obstetrics departments at 1,170 hospitals in Japan. Turnover intention was assessed using two items: intention to leave the current hospital and intention to leave the nursing or midwifery profession, both measured by frequency. Multivariate logistic regression analyses were performed, with high-frequency turnover intention (at least once per week) as the dependent variable and respondents' demographic characteristics and working conditions as independent variables. Results Valid responses were obtained from 2,043 nurses and midwives at 474 hospitals, corresponding to a hospital-level response rate of 40.5%. Overall, 494 (24.2%) respondents reported thinking about leaving their current hospital at least once per week, and 199 (22.2%) reported thinking about leaving the nursing or midwifery profession at least once per week. Longer weekly working hours were associated with greater intention to leave the current hospital, with a dose-response pattern across the 50-59, 60-69, and ≥70-hour categories. Holding a head nurse position, working in facilities with more midwives or at least 10 advanced midwives, and employment at university hospitals were associated with lower intention to leave the current hospital. Intention to leave the profession was higher among respondents working ≥70 hours per week, whereas holding a head nurse position, having at least 10 advanced midwives, employment at university hospitals, and working outside urban areas were associated with lower intention to leave the profession. Conclusions Among nurses and midwives working in obstetrics departments in Japan, very long working hours were associated with higher turnover intention, whereas organizational factors-including managerial roles, staffing resources within the same profession, university-hospital employment, and regional setting-were associated with lower turnover intention. Based on nationwide, department-specific data, this study highlights the importance of addressing turnover intention not only as an individual issue but also as an organizational and structural problem, providing evidence to inform workforce retention strategies and policy discussions aimed at improving working conditions.

Source: Cureus

DOI: 10.7759/cureus.117162