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. 2025 Sep 5:16:1486949.
doi: 10.3389/fpsyg.2025.1567583. eCollection 2025.

Turnover intention and the moderating role of career shocks an empirical study of medical staff in public hospitals in Guangzhou, China

Fan Yang  1   2 , Henrique Duarte  3 , Jianping Chen  4 , Chenxi Zu  5
Affiliations

Turnover intention and the moderating role of career shocks an empirical study of medical staff in public hospitals in Guangzhou, China

Fan Yang et al. Front Psychol. .

Abstract

Objective: This study aims to explore how Leader-Member Exchange (LMX), Job Embeddedness (JE), Job Satisfaction (JS), and Career shocks (CS) affect hospital staff's turnover intention. By offering theoretical and practical insights, it reassures the reader of the study's value in curbing employee departures and building a more stable workforce.

Methods: Using a longitudinal design and self-administered questionnaires, data were collected in two rounds from 500 medical staff in 12 tertiary public hospitals in Guangzhou, China, between May and September 2023. The data were analyzed with SPSS 26 and PROCESS macro for SPSS 4.1, including descriptive statistics, correlation analysis, and mediation and moderation analyses.

Results: LMX, JE, and JS were significantly negatively correlated with Turnover Intention (TI) (r = -0.365, p < 0.01; r = -0.571, p < 0.01; r = -0.517, p < 0.01). JS fully mediated the link between LMX and TI (ab = -0.384, 95%CI: [-0.497, -0.285]) and partially mediated the link between JE and TI (ab = -0.237, 95%CI: [-0.350, -0.123]). CS significantly moderates these relationships: positive CS enhanced employees' JE and JS, while negative CS weakened organizational commitment and increased turnover likelihood.

Discussion: CS can temporarily intensify the relationships between LMX, JE, JS, and TI under certain circumstances, likely due to heightened employee sensitivity to leadership support, work environment, and career development. This moderation effect also highlights that employees' demand for organizational support increases when facing career challenges, and high-quality LMX and JE can provide essential assistance for employees to navigate career shocks.

Conclusion: By investigating the impact of LMX, JE, JS, and CS on turnover intention, this study offers a fresh perspective on the occupational behavior of medical staff in public hospitals. The findings not only enrich LMX and career shocks theories but also provide practical guidance for managers. This guidance empowers managers to reduce employee turnover intention, making them feel capable and ready to implement these strategies. As a primary goal, the abstract should render the general significance and conceptual advance of the work clearly accessible to a broad readership. References should not be cited in the abstract. Leave the Abstract empty if your article does not require one - please see the "Article types" on every Frontiers journal page for full details.

Keywords: career shocks; job embeddedness; job satisfaction; leader-member exchange; medical staff; public hospitals; turnover intention.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Diagram illustrating the relationships between Leader-Member Exchange, Job Satisfaction, Job Embeddedness, Career Shocks, and Turnover Intention. Arrows indicate Hypotheses (H1-H5) representing the influence paths. Leader-Member Exchange affects Job Satisfaction and Turnover Intention. Job Satisfaction is influenced by both Leader-Member Exchange and Job Embeddedness. Career Shocks have direct and indirect effects on Turnover Intention through Job Satisfaction and Job Embeddedness.
FIGURE 1
Framework diagram.
Line graph showing turnover intention against leadership-member exchange. An orange line indicates high positive career shocks, declining from 2.7 to 1.8. A blue line for low positive career shocks remains steady around 2.1.
FIGURE 2
Moderation of positive career shocks to leadership-member exchange and turnover intention.
Line graph showing turnover intention against job satisfaction. The graph features two lines: blue for low positive career shocks and orange for high positive career shocks. Both lines decline from low to high job satisfaction, with a sharper decline in the blue line.
FIGURE 3
Moderation of positive career shocks to job satisfaction and turnover intention.
Line graph showing turnover intention on the y-axis and job embeddedness on the x-axis. Two lines represent low and high positive career shocks. Both lines decrease as job embeddedness increases.
FIGURE 4
Moderation of positive career shocks to job embeddedness and turnover intention.
Line graph showing the relationship between job satisfaction and turnover intention. Two lines compare the effects of low and high positive career shocks. The blue line indicates a sharper decline in turnover intention with low positive career shocks, while the orange line shows a smaller decline with high positive career shocks as job satisfaction increases.
FIGURE 5
Moderation of positive career shocks to job satisfaction and turnover intention.
Line graph showing turnover intention against leadership-member exchange. Two lines represent low and high negative career shocks. Low shocks remain constant, while high shocks decrease significantly from low to high exchange levels.
FIGURE 6
Moderation of negative career shocks to leadership-member exchange and turnover intention.
Line graph showing turnover intention against job satisfaction. Two lines represent low and high negative career shocks. Turnover intention decreases with higher job satisfaction for both lines, more sharply for low negative career shocks.
FIGURE 7
Moderation of negative career shocks to job satisfaction and turnover intention.
Line graph showing the relationship between job embeddedness and turnover intention. The x-axis represents job embeddedness from low to high, and the y-axis represents turnover intention from 1 to 3. Two lines are shown: blue for low negative career shocks, decreasing from 2.2 to 1.8, and orange for high negative career shocks, decreasing from 2.8 to 1.7.
FIGURE 8
Moderation of negative career shocks to job embeddedness and turnover intention.
Line graph showing the relationship between job satisfaction and turnover intention, with two lines representing low and high negative career shocks. Both lines show decreased turnover intention from low to high job satisfaction, with a steeper decrease for low negative career shocks.
FIGURE 9
Moderation of negative career shocks to job satisfaction and turnover intention.
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