Intention to leave the nursing profession due to mental health factors in Navarre (Spain) during the post.COVID-19 pandemic period

Authors

DOI:

https://doi.org/10.23938/ASSN.1110

Keywords:

Pandemic COVID-19, 19Nurses, Job satisfaction, Mental Health, Surveys and Questionnaires

Abstract

Background. This study aimed to assess the intention to leave the current job or the nursing profession among nurses in the Foral Community of Navarre (Spain) during the sixth wave of the COVID-19 pandemic (October 2021-March 2022). The research also evaluated associations between this intention and nurses´ mental health status and sociodemographic characteristics.

Methods. Descriptive, cross-sectional study that included nurses who worked in healthcare institutions in Navarre during the COVID-19 pandemic. A questionnaire was designed using validated scales to assess depression, anxiety, insomnia, post-traumatic stress, and the intention to leave the job or profession. The questionnaire was distributed via e-mail to all registered nurses, and data collection concluded upon reaching the required sample size.

Results. Of the 693 nurses who participated, 691 completed the questionnaire in full. Overall, 43% of respondents reported an intention to leave the nursing profession, and of these, 52% also considered leaving the current job. Nurses experiencing higher levels of anxiety and post-traumatic stress, as well as those with fewer years of professional experience, were significantly more likely to report an intention to leave.

Conclusions. A substantial proportion of nurses in Navarre considered leaving the profession during the sixth wave of the COVID-19 pandemic, with mental health -particularly anxiety and post-traumatic stress - and limited professional experience being the key contributing factors. These findings underscore the need for targeted interventions to support nurses´ mental health, improve working conditions, and mitigate job abandonment during and after public health emergencies.

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Author Biographies

Cristina García-Vivar, Universidad Pública de Navarra (UPNA). Departamento de Ciencias de la Salud. Pamplona. España

Universidad Pública de Navarra (UPNA). Departamento de Ciencias de la Salud. Pamplona. España https://ror.org/02z0cah89

Instituto de Investigación Sanitaria de Navarra (IdiSNA). Pamplona. España https://ror.org/023d5h353

Marta Ferraz-Torres, Marta

Universidad Pública de Navarra (UPNA). Departamento de Ciencias de la Salud. Pamplona. España https://ror.org/02z0cah89

Instituto de Investigación Sanitaria de Navarra (IdiSNA). Pamplona. España https://ror.org/023d5h353

Paula Escalada-Hernández, Universidad Pública de Navarra (UPNA). Departamento de Ciencias de la Salud. Pamplona. España

Universidad Pública de Navarra (UPNA). Departamento de Ciencias de la Salud. Pamplona. España https://ror.org/02z0cah89

Instituto de Investigación Sanitaria de Navarra (IdiSNA). Pamplona. España https://ror.org/023d5h353

nelia.soto@unavarra.es, Universidad Pública de Navarra (UPNA). Departamento de Ciencias de la Salud. Pamplona. España

Universidad Pública de Navarra (UPNA). Departamento de Ciencias de la Salud. Pamplona. España https://ror.org/02z0cah89

Instituto de Investigación Sanitaria de Navarra (IdiSNA). Pamplona. España https://ror.org/023d5h353

References

. Organización Mundial de la Salud (OMS). Coronavirus Disease (COVID-19) epidemiological update. https://cdn.who.int/media/docs/default-source/documents/emergencies/20241224_covid-19_epi_update_special-edition.pdf

Ministerio de Sanidad. Evolución de La Enfermedad Por COVID-19 En España. Informes de situación publicados durante la crisis sanitaria. https://www.sanidad.gob.es/areas/alertasEmergenciasSanitarias/alertasActuales/nCov/evolucion/situacion.htm

Erdem H, Lucey DR. Healthcare worker infections and deaths due to COVID-19: A survey from 37 nations and a call for WHO to post national data on their website. Int J Infect Dis 2021; 102: 239–241. https://doi.org/10.1016/j.ijid.2020.10.064

Olivas-Martínez A, Cárdenas-Fragoso JL, Jiménez JV, Lozano-Cruz OA, Ortiz-Brizuela E, Tovar-Méndez VH et al. In-hospital mortality from severe COVID-19 in a tertiary care center in Mexico City; causes of death, risk factors and the impact of hospital saturation. Lazzeri C. ed. Plos One 2021; 16(2): e0245772. https://doi.org/10.1371/journal.pone.0245772

Davidson PM, Szanton SL. Nursing homes and COVID‐19: We can and should do better. J Clin Nurs 2020; 29(15-16): 2758-2759. https://doi.org/10.1111/jocn.15297

Saragih ID, Tonapa SI, Saragih IS, Advani S, Batubara SO, Suarilah I et al. Global prevalence of mental health problems among healthcare workers during the Covid-19 pandemic: A systematic review and meta-analysis. Int J Nurs Stud 2021; 121: 104002-104002. https://doi.org/10.1016/j.ijnurstu.2021.104002

García-Vivar C, Rodríguez-Matesanz I, San Martín-Rodríguez L, Soto-Ruiz N, Ferraz-Torres M, Escalada-Hernández P. Analysis of mental health effects among nurses working during the COVID ‐19 pandemic: A systematic review. J Psychiatr Ment Health Nurs 2023; 30(3): 326-340. https://doi.org/10.1111/jpm.12880

Sabetian G, Moghadami M, Hashemizadeh Fard Haghighi L, Shahriarirad R, Fallahi MJ, Asmarian N et al. COVID-19 infection among healthcare workers: a cross-sectional study in southwest Iran. Virol J 2021; 18(1): 58. https://doi.org/10.1186/s12985-021-01532-0

Carriero MC, Conte L, Calignano M, Lupo R, Calabrò A, Santoro P et al. The psychological impact of the coronavirus emergency on physicians and nurses: An Italian observational study. Acta Biomed Atenei Parm 2021; 92(Suppl 2): e2021030. https://doi.org/10.23750/abm.v92iS2.11575

Martin-Rodriguez LS, Escalda-Hernandez P, Soto-Ruiz N, Ferraz-Torres M, Rodriguez-Matesanz I, Garcia-Vivar C. Mental health of Spanish nurses working during the COVID‐19 pandemic: A cross‐sectional study. Int Nurs Rev 2022; 69(4): 538-545. https://doi.org/10.1111/inr.12764

García-Iglesias JJ, Gómez-Salgado J, Martín-Pereira J, Fagundo-Rivera J, Ayuso-Murillo D, Martínez-Riera JR et al. Impacto del SARS-CoV-2 (COVID-19) en la salud mental de los profesionales sanitarios: Una revisión sistemática. Rev Esp Salud Publica 2020; 94: e202007088. https://ojs.sanidad.gob.es/index.php/resp/article/view/888

Labrague LJ, De Los Santos JAA. COVID-19 anxiety among front-line nurses: Predictive role of organisational support, personal resilience and social support. J Nurs Manag 2020; 28(7): 1653-1661. https://doi.org/10.1111/JONM.13121

Ulupinar F, Erden Y. Intention to leave among nurses during the COVID-19 outbreak: A rapid systematic review and meta-analysis. J Clin Nurs 2022; 3(1): 393-403. https://doi.org/10.1111/jocn.16588

Kachadourian LK, Feder A, Murrough JW, Feingold JH, Kaye-Kauderer H, Charney D et al. Transdiagnostic psychiatric symptoms, burnout, and functioning in frontline health care workers responding to the COVID-19 pandemic: A symptomics analysis. J Clin Psychiatry 2021; 82(3): 20m13766. https://doi.org/10.4088/JCP.20m13766

Flinkman M, Leino-Kilpi H, Salanterä S. Nurses’ intention to leave the profession: integrative review. J Adv Nurs 2010; 66(7): 1422-1434. https://doi.org/10.1111/j.1365-2648.2010.05322.x

Zhang LF, You LM, Liu K, Zheng J, Fang JB, Lu MM et al. The association of Chinese hospital work environment with nurse burnout, job satisfaction, and intention to leave. Nurs Outlook 2014; 62(2): 128-137. https://doi.org/10.1016/j.outlook.2013.10.010

Heinen MM, Van Achterberg T, Schwendimann R, Zander B, Matthews A, Kózka M et al. Nurses’ intention to leave their profession: A cross sectional observational study in 10 European countries. Int J Nurs Stud 2013; 50(2): 174-184. https://doi.org/10.1016/j.ijnurstu.2012.09.019

Chang A, Douglas M, Breen-Reid K, Gueorguieva V, Fleming-Carroll B. Preceptors’ perceptions of their role in a pediatric acute care setting. J Contin Educ Nurs 2013; 44(5): 211-217. https://doi.org/10.3928/00220124-20130315-81

Aparicio C, Nicholson J. Do preceptorship and clinical supervision programmes support the retention of nurses? Br J Nurs 2020; 29(20): 1192-1197. https://doi.org/10.12968/bjon.2020.29.20.1192

Giménez-Díez D, Leyva-Moral JM, Watson CE, Bernabeu-Tamayo MD. Mental health status and the intention to leave the profession of nurses employed across Catalonia, Spain: A cross-sectional study. J Psychiatr Ment Health Nurs 2025; 32: 371-381. https://doi.org/10.1111/jpm.13116

Leary A, Maxwell E, Myers R, Punshon G. Why are healthcare professionals leaving NHS roles? A secondary analysis of routinely collected data. Hum Resour Health 2024; 22(1): 65. https://doi.org/10.1186/s12960-024-00951-8

Instituto de Salud Carlos III. Centro Nacional de Epidemiología. Informe No 181. Situación de COVID-19 en España a 30 de junio de 2023. https://repisalud.isciii.es/rest/api/core/bitstreams/18923687-acd7-46db-b8d5-cdaf6e6618a8/content

Galbany-Estragués P, Milán-Martinez P. Escasez de enfermeras en España: el caso global a la situación particular. Informe SESPAS 2024. Gac Sanit 2024; 38(Suppl 1): 102376. https://doi.org/10.1016/j.gaceta.2024.102376

Organisation for Economic Co-operation and Development (OCDE). Indicators: Nurses. https://data.oecd.org/healthres/nurses.htm

International Council of Nurses. The Global Nursing Shortage and Nurse Retention. ICN Policy Brief. International Council of Nurses; 2021. https://www.icn.ch/sites/default/files/inline-files/ICN%20Policy%20Brief_Nurse%20Shortage%20and%20Retention_0.pdf

Raso R, Fitzpatrick JJ, Masick K. Nurses’ intent to leave their position and the profession during the COVID-19 pandemic. J Nurs Adm 2021; 51(10): 488-494. https://doi.org/10.1097/NNA.0000000000001052

Pappa S, Ntella V, Giannakas T, Giannakoulis VG, Papoutsi E, Katsaounou P. Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Brain Behav Immun 2020; 88: 901-907. https://doi.org/10.1016/j.bbi.2020.05.026

Kocalevent RD, Hinz A, Brähler E. Standardization of the depression screener Patient Health Questionnaire (PHQ-9) in the general population. Gen Hosp Psychiatry 2013; 35(5): 551-555. https://doi.org/10.1016/j.genhosppsych.2013.04.006

Diez-Quevedo C, Rangil T, Sanchez-Planell L, Kroenke K, Spitzer RL. Validation and utility of the Patient Health Questionnaire in diagnosing mental disorders in 1003 general hospital Spanish inpatients. Psychosom Med 2001; 63(4): 679–686. https://doi.org/10.1097/00006842-200107000-00021

Löwe B, Decker O, Müller S, Brähler E, Schellberg D, Herzog W et al. Validation and standardization of the Generalized Anxiety Disorder Screener (GAD-7) in the general population. Med Care 2008; 46(3): 266-274. https://doi.org/10.1097/MLR.0b013e318160d093

García-Campayo J, Zamorano E, Ruiz MA, Pardo A, Pérez-Páramo M, López-Gómez V et al. Cultural adaptation into Spanish of the generalized anxiety disorder-7 (GAD-7) scale as a screening tool. Health Qual Life Outcomes 2010; 8(1): 8. https://doi.org/10.1186/1477-7525-8-8

Sierra JC, Guillén-Serrano V, Santos-Iglesias P. Insomnia Severity Index: algunos indicadores acerca de su fiabilidad y validez en una muestra de personas mayores. Rev Neurol 2008; 47(11): 566-570. https://doi.org/10.33588/rn.4711.2008221

Horowitz M, Wilner N, Alvarez W. Impact of Event Scale: A measure of subjective stress. Psychosom Med 1979; 41(3): 209-218. https://doi.org/10.1097/00006842-197905000-00004

Dobson H, Malpas CB, Burrell AJ, Gurvich C, Chen L, Kulkarni J et al. Burnout and psychological distress amongst Australian healthcare workers during the COVID-19 pandemic. Australas Psychiatry 2021; 29(1): 26-30. https://doi.org/10.1177/1039856220965045

Riello M, Purgato M, Bove C, Mactaggart D, Rusconi E. Prevalence of post-traumatic symptomatology and anxiety among residential nursing and care home workers following the first COVID-19 outbreak in Northern Italy. R Soc Open Sci 2020; 7(9): 200880-200880. https://doi.org/10.1098/rsos.200880

Şahin MK, Aker S, Şahin G, Karabekiroğlu A. Prevalence of depression, anxiety, distress and insomnia and related factors in healthcare workers during COVID-19 pandemic in Turkey. J Community Health 2020; 45(6): 1168-1177. https://doi.org/10.1007/s10900-020-00921-w

Moreira A, Lucca S. [Apoyo psicosocial y salud mental de los profesionales de enfermería en la lucha contra la COVID-19]. Enfermagem em Foco 2020; 11(1): 155-161. https://doi.org/10.21675/2357-707X.2020.v11.n1.ESP.3590

Maunder RG, Heeney ND, Jeffs LP, Wiesenfeld LA, Hunter JJ. A longitudinal study of hospital workers' mental health from fall 2020 to the end of the COVID-19 pandemic in 2023. Sci Rep. 2024; 14(1): 26137. https://doi.org/10.1038/s41598-024-77493-5

Jung H, Jung SY, Lee MH, Kim MS. Assessing the presence of post-traumatic stress and turnover intention among nurses post–middle east respiratory syndrome outbreak: The importance of supervisor support. Workplace Health Saf 2020; 68(7): 337-345. https://doi.org/10.1177/2165079919897693

Zhang Y, Wei L, Li H, Pan Y, Wang J, Li Q et al. The psychological change process of frontline nurses caring for patients with COVID-19 during its outbreak. Issues Ment Health Nurs 2020; 41(6): 525-530. https://doi.org/10.1080/01612840.2020.1752865

Cai H, Tu B, MA J, Chen L, Fu L, Jiang Y et al. Psychological impacts and coping strategies of front-line medical staff during COVID-19 outbreak in Hunan, China. Med Sci Monit 2020; 26: e924171. https://doi.org/10.12659/MSM.924171.

Camerino D, Conway PM, Van Der Heijden BI, Estryn-Behar M, Consonni D, Gould D et al. Low-perceived work ability, ageing and intention to leave nursing: a comparison among 10 European countries. J Adv Nurs 2006; 56(5): 542-552. https://doi.org/10.1111/j.1365-2648.2006.04046.x

San Martín-Rodríguez L, García-Vivar C, Escalada-Hernández P, Soto-Ruiz N. Las enfermeras tras la pandemia por COVID-19: ¿Ahora qué? Enferm Clin 2022; 32(1): 1-3. https://doi.org/10.1016/j.enfcli.2021.12.003

Leineweber C, Chungkham Hs, Lindqvist R, Westerlund H, Runesdotter S, Smeds Alenius L et al; RN4CAST consortium. Nurses' practice environment and satisfaction with schedule flexibility is related to intention to leave due to dissatisfaction: A multi-country, multilevel study. Int J Nurs Stud. 2016; 58: 47-58. https://doi.org/10.1016/j.ijnurstu.2016.02.003

Watson CE, Bernabeu-Tamayo MD, Giménez-Díez D, Lillo-Crespo M, Leyva-Moral JM. Factors contributing to nurses’ intention to leave the profession: A qualitative study in Catalonia, Spain, following the latest waves of COVID-19. J Nurs Manag. 2024; 1: 7971020. https://doi.org/10.1155/2024/7971020

Published

2025-04-30

How to Cite

1.
García-Vivar C, Ferraz-Torres M, Escalada-Hernández P, Soto-Ruiz N. Intention to leave the nursing profession due to mental health factors in Navarre (Spain) during the post.COVID-19 pandemic period. An Sist Sanit Navar [Internet]. 2025 Apr. 30 [cited 2026 Feb. 12];48(1):e1110. Available from: https://recyt.fecyt.es/index.php/ASSN/article/view/110374

Issue

Section

Research articles

Funding data

  • PreferenciasDepartamento de Salud, Gobierno de Navarra http://dx.doi.org/10.13039/501100016120
    Grant numbers [proyecto número 0011-3638-2020-000005]

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