Reducing Nurses’ Emotional Exhaustion and Turnover Intentions: The Role of Prosocial Orientation and Perceived Patient Gratitude in a Moderated Mediation Model

Aims: This study investigates the relationship between prosocial orientation and turnover intention among Italian nurses, examining the mediating role of emotional exhaustion and the moderating effect of perceived patient gratitude. Design: Cross-sectional quantitative study. Methods: A sample of 162 nurses employed in Italian hospitals completed an online survey on the Qualtrics platform assessing prosocial orientation, patient gratitude, emotional exhaustion, and turnover intention. Data were analyzed through a moderated mediation model via the PROCESS macro in JASP. Results: Prosocial orientation was negatively associated with turnover intention, with emotional exhaustion acting as a mediator in this relationship. Perceived patient gratitude moderated the impact of prosocial orientation on emotional exhaustion. The conditional indirect effect of prosocial orientation on turnover intention through emotional exhaustion was significant at average and high levels of patient gratitude, but not at low levels. Conclusion: The findings suggest that fostering prosocial orientation perceptions and enhancing patient gratitude and its perceptions can mitigate emotional exhaustion and reduce turnover intentions among nurses. Implications for Nursing Management: Healthcare organizations can promote prosocial orientation and patient gratitude through training, feedback, and recognition events to reduce nurses’ emotional exhaustion and turnover.