Psychological and Organizational Determinants of Healthcare Workers’ Retention in Geriatric Care: A Systematic Review

Authors

  • Ninik Dwi Rahayu Universitas Airlangga
  • Joni Haryanto Universitas Airlangga
  • Dianis Wulan Sari Universitas Airlangga

DOI:

https://doi.org/10.37287/ijghr.v8i2.710

Keywords:

burnout, geriatric nursing, intrinsic motivation, nurse retention, organizational support

Abstract

The increasing elderly population increases the demand for geriatric care, while nurse retention remains a major concern due to high workloads, emotional demands, and limited organizational support. High turnover disrupts care continuity and reduces service quality. This systematic review aims to identify key psychological and organizational factors influencing geriatric nurse retention. Method: The review followed PRISMA 2023 guidelines using the PEOS framework. Quantitative cross-sectional studies published between 2015–2025 were retrieved from PubMed, Web of Science, ProQuest, Springer Nature, and ScienceDirect. Study quality was evaluated using the JBI Critical Appraisal Checklist. A total of 13 studies met the inclusion criteria, while 28,076 were excluded. Findings were narratively synthesized to integrate the overall evidence. Thirteen studies from multiple countries identified five main themes: psychological and organizational factors, individual characteristics, student interest, and the interaction between personal and institutional conditions. Intrinsic motivation, social and organizational support, and safe, flexible work environments enhance retention, whereas burnout, excessive workload, and low salary reduce retention intentions.  Geriatric nurse retention is influenced by psychological, social, and organizational factors. Supportive leadership, flexible work policies, and early geriatric education are important for sustaining long-term engagement in geriatric nursing.

References

AbdELhay, E. S., Taha, S. M., El-Sayed, M. M., Helaly, S. H., & AbdELhay, I. S. (2025). Nurses retention: the impact of transformational leadership, career growth, work well-being, and work-life Balance. BMC Nursing, 24(1), 148. https://doi.org/10.1186/s12912-025-02762-1

Amiri, M., Velzi, D., Mirhosseini, S., & Khosravi, A. (2025). Intention to Leave the Profession in Iranian Nurses: The Predictive Role of Organizational Commitment and Burnout. Shahroud Journal of Medical Sciences, 11(2), 40 – 46. https://doi.org/10.22100/ijhs.v11i2.1185

Bae, S. (2022). Noneconomic and economic impacts of nurse turnover in hospitals: A systematic review. International Nursing Review, 69(3), 392–404. https://doi.org/10.1111/inr.12769

Bell, M., & Sheridan, A. (2020). How organisational commitment influences nurses’ intention to stay in nursing throughout their career. International Journal of Nursing Studies Advances, 2, 100007. https://doi.org/10.1016/j.ijnsa.2020.100007

Berthelsen, C., & Hansen, C. A. (2024). SHOULD I STAY OR SHOULD I GO–A rapid qualitative study of principal deteriorating factors experienced by nurses relating to their intentions to leave their current position in a medical hospital department. Scandinavian Journal of Caring Sciences, 38(3), 692 – 700. https://doi.org/10.1111/scs.13246

Bradford, A. D., & Burrell, D. N. (2025). Case study: Risk management strategies to reduce nurse turnover and improve retention. In New Horizons in Leadership: Inclusive Explorations in Health, Technology, and Education (pp. 257–290). https://doi.org/10.4018/979-8-3693-6437-6.ch012

Callado, A., Teixeira, G., & Lucas, P. (2023). Turnover Intention and Organizational Commitment of Primary Healthcare Nurses. Healthcare (Switzerland), 11(4). https://doi.org/10.3390/healthcare11040521

Deci, E. L., & Ryan, R. M. (2000). The “what” and “why” of goal pursuits: Human needs and the self-determination of behavior. Psychological Inquiry, 11(4), 227–268. https://doi.org/10.1207/S15327965PLI1104_01

Dierckx de Casterlé, B., Mertens, E., Steenacker, J., & Denier, Y. (2020). Nurses’ experiences of working under time pressure in care for older persons. Nursing Ethics, 27(4), 979–990. https://doi.org/10.1177/0969733019895797

Elshaer, I. A., Azazz, A. M. S., Kooli, C., Aljoghaiman, A., Elsawy, O., & Fayyad, S. (2025). Green Transformational Leadership’s Impact on Employee Retention: Does Job Satisfaction and Green Support Bridge the Gap? Administrative Sciences, 15(5). https://doi.org/10.3390/admsci15050177

Eltaybani, S., Noguchi-Watanabe, M., Igarashi, A., Saito, Y., & Yamamoto-Mitani, N. (2018a). Factors related to intention to stay in the current workplace among long-term care nurses: A nationwide survey. International Journal of Nursing Studies, 80, 118–127. https://doi.org/10.1016/j.ijnurstu.2018.01.008

Eltaybani, S., Noguchi-Watanabe, M., Igarashi, A., Saito, Y., & Yamamoto-Mitani, N. (2018b). Factors related to intention to stay in the current workplace among long-term care nurses: A nationwide survey. International Journal of Nursing Studies, 80, 118–127. https://doi.org/10.1016/j.ijnurstu.2018.01.008

Fehr, L., & Koob, C. (2025). Associations between key job resources, job demands, and affective organizational commitment among nursing professionals in German hospitals: a cross-sectional study. BMC Nursing, 24(1), 442. https://doi.org/10.1186/s12912-025-03033-9

Gandhi, A., Yu, H., & Grabowski, D. C. (2021). High Nursing Staff Turnover In Nursing Homes Offers Important Quality Information. Health Affairs (Project Hope), 40(3), 384–391. https://doi.org/10.1377/hlthaff.2020.00957

Garbrah, W., Kankkunen, P., & Välimäki, T. (2020). Gerontological nurse teachers’ abilities and influence on students’ willingness in older people nursing: A cross-sectional, correlational survey. Nurse Education Today, 90. https://doi.org/10.1016/j.nedt.2020.104461

Gilmartin, M. J. (2023). Nurses Improving Care for Health Systems Elders (NICHE): An evidence-based professional practice model for an aging nation. Geriatric Nursing, 53, 310–312. https://doi.org/10.1016/j.gerinurse.2023.08.002

Guo, Y., Yang, L., Zhu, L., Wan, Y., Zhang, S., & Zhang, J. (2021). Willingness and associated factors of working with older people among undergraduate nursing students in China: a cross-sectional study. BMC Nursing, 20(1), 1–9. https://doi.org/10.1186/s12912-021-00639-7

Hagiwara, Y., Pagan-Ferrer, J., & Sanchez-Reilly, S. (2020). Impact of an early-exposure geriatrics curriculum in an accelerated baccalaureate-MD program. Gerontology and Geriatrics Education, 41(4), 508 – 513. https://doi.org/10.1080/02701960.2018.1464919

Halcomb, E., & Bird, S. (2020). Job Satisfaction and Career Intention of Australian General Practice Nurses: A Cross-Sectional Survey. Journal of Nursing Scholarship : An Official Publication of Sigma Theta Tau International Honor Society of Nursing, 52(3), 270–280. https://doi.org/10.1111/jnu.12548

Hensen, B., Floyd, S., Phiri, M. M., Schaap, A., Sigande, L., Simuyaba, M., Mwenge, L., Zulu-Phiri, R., Mwape, L., Fidler, S., Hayes, R., Simwinga, M., & Ayles, H. (2023). The impact of community-based, peer-led sexual and reproductive health services on knowledge of HIV status among adolescents and young people aged 15 to 24 in Lusaka, Zambia: The Yathu Yathu cluster-randomised trial. PLoS Medicine, 20(4), 1–22. https://doi.org/10.1371/journal.pmed.1004203

Hoxha, S., & Ramadani, R. (2024). The Impact of Intrinsic Motivation on the Sustainable Extra-Role Performance with the Mediating Role of Job Engagement. Sustainability (Switzerland), 16(17). https://doi.org/10.3390/su16177643

Kurnat-Thoma, E., Ganger, M., Peterson, K., & Channell, L. (2017). Reducing annual hospital and registered nurse staff turnover—A 10-element onboarding program intervention. SAGE Open Nursing, 3, 2377960817697712.

Layek, D., & Koodamara, N. K. (2025). Motivation on contextual performance in healthcare settings: the influence of work engagement and transformational leadership. International Journal of Healthcare Management. https://doi.org/10.1080/20479700.2025.2520945

Lent, R. W., Brown, S. D., & Hackett, G. (1994). Toward a Unifying Social Cognitive Theory of Career and Academic Interest, Choice, and Performance. Journal of Vocational Behavior, 45(1), 79–122. https://doi.org/10.1006/jvbe.1994.1027

Li, X., Zhang, Y., Yan, D., Wen, F., & Zhang, Y. (2020). Nurses’ intention to stay: The impact of perceived organizational support, job control and job satisfaction. Journal of Advanced Nursing, 76(5), 1141–1150. https://doi.org/10.1111/jan.14305

Liang, H. Y., Tseng, T. Y., Dai, H. Da, Chuang, J. Y., & Yu, S. (2023). The relationships among overcommitment, effort-reward imbalance, safety climate, emotional labour and quality of working life for hospital nurses: a structural equation modeling. BMC Nursing, 22(1), 204. https://doi.org/10.1186/s12912-023-01355-0

Lucas, P., Jesus, É., Almeida, S., Costa, P., Cruchinho, P., Teixeira, G., & Araújo, B. (2025). The Nursing Practice Environment and Job Satisfaction, Intention to Leave, and Burnout Among Primary Healthcare Nurses: A Cross-Sectional Study. Nursing Reports, 15(7). https://doi.org/10.3390/nursrep15070224

Marjerison, R. K., Jun, J. Y., Kim, J. M., & Kuan, G. (2025). Motivation, Urban Pressures, and the Limits of Satisfaction: Insights into Employee Retention in a Changing Workforce. Systems, 13(8). https://doi.org/10.3390/systems13080661

Okuyan, C. B., Bilgili, N., & Mutlu, A. (2020). Factors affecting nursing students’ intention to work as a geriatric nurse with older adults in Turkey: A cross-sectional study. Nurse Education Today, 95, 104563. https://doi.org/10.1016/j.nedt.2020.104563

Pula, G., Moretti, P., Ritacco, I., Caramanico, G., De Filippis, G., Magnone, R., & Tortorella, A. (2025). OCCUPATIONAL STRESS AND ITS ASSOCIATION WITH AFFECTIVE DISORDERS IN HEALTHCARE WORKERS: A CROSS-SECTIONAL STUDY. Psychiatria Danubina, 37, 385 – 390. https://www.scopus.com/inward/record.uri?eid=2-s2.0-105016768402&partnerID=40&md5=4b5c0a073557ce41a33420e27b30b71e

Randa, M. B., & Phale, J. M. (2023). The effects of high nurses’ turnover on patient care: Perspectives of unit managers in critical care units. International Journal of Africa Nursing Sciences, 19. https://doi.org/10.1016/j.ijans.2023.100580

Rathnayake, S., Athukorala, Y., & Siop, S. (2016). Attitudes toward and willingness to work with older people among undergraduate nursing students in a public university in Sri Lanka: A cross sectional study. Nurse Education Today, 36, 439–444. https://doi.org/10.1016/j.nedt.2015.10.007

Saito, Y., Igarashi, A., Noguchi-Watanabe, M., Takai, Y., & Yamamoto-Mitani, N. (2018). Work values and their association with burnout/work engagement among nurses in long-term care hospitals. Journal of Nursing Management, 26(4), 393–402. https://doi.org/10.1111/jonm.12550

Shoki, R., Kono, A., Hirano, Y. O., Barroga, E., Ota, E., & Nagamatsu, Y. (2023). Factors Related to Job Continuance of Nurses Who Migrated to Japan: A Cross-Sectional Study. Nursing Reports (Pavia, Italy), 14(1), 25–41. https://doi.org/10.3390/nursrep14010003

Shrivastava, P., & Ali, S. S. A. S. S. (2025). Analyzing the impact of aging populations on healthcare system sustainability. Journal of Neonatal Surgery, 14(1), 393 – 397. https://doi.org/10.52783/jns.v14.1554

Sommer, D., Wilhelm, S., & Wahl, F. (2024). Nurses’ Workplace Perceptions in Southern Germany-Job Satisfaction and Self-Intended Retention towards Nursing. Healthcare (Basel, Switzerland), 12(2). https://doi.org/10.3390/healthcare12020172

Väisänen, V., Ruotsalainen, S., Hietapakka, L., Sulander, J., & Sinervo, T. (2024). The role of workday characteristics on perceived stress and time pressure among nurses in Finnish long-term care – a cross-sectional study. BMC Health Services Research, 24(1). https://doi.org/10.1186/s12913-024-11294-4

Vander Weerdt, C., Kosteas, V. D., DeRigne, L., & Stoddard-Dare, P. (2025). The role of paid time off, flexible scheduling and job satisfaction in voluntary turnover. International Journal of Manpower. https://doi.org/10.1108/IJM-09-2024-0632

Wang, H., Jin, Y., Wang, D., Zhao, S., Sang, X., & Yuan, B. (2020). Job satisfaction, burnout, and turnover intention among primary care providers in rural China: Results from structural equation modeling. BMC Family Practice, 21(1). https://doi.org/10.1186/s12875-020-1083-8

Wang, T., Abrantes, A. C. M., & Liu, Y. (2023). Intensive care units nurses’ burnout, organizational commitment, turnover intention and hospital workplace violence: A cross-sectional study. Nursing Open, 10(2), 1102 – 1115. https://doi.org/10.1002/nop2.1378

Wang, Z., Guan, C., Cui, T., Cai, S., & Liu, D. (2021). Servant Leadership, Team Reflexivity, Coworker Support Climate, and Employee Creativity: A Multilevel Perspective. Journal of Leadership and Organizational Studies, 28(4), 465 – 478. https://doi.org/10.1177/15480518211010769

Wollesen, B., Hagemann, D., Pabst, K., Schlüter, R., Bischoff, L. L., Otto, A.-K., Hold, C., & Fenger, A. (2019). Identifying individual stressors in geriatric nursing staff-a cross-sectional study. International Journal of Environmental Research and Public Health, 16(19). https://doi.org/10.3390/ijerph16193587

Xie, A., Xu, G., & Duff, J. (2024). Exploring wellbeing and turnover intention among perioperative nurses: A discussion paper. Journal of Perioperative Nursing, 37(4), e–4 – e–11. https://doi.org/10.26550/2209-1092.1338

Zeng, D., Takada, N., Hara, Y., Sugiyama, S., Ito, Y., Nihei, Y., & Asakura, K. (2022). Impact of Intrinsic and Extrinsic Motivation on Work Engagement: A Cross-Sectional Study of Nurses Working in Long-Term Care Facilities. International Journal of Environmental Research and Public Health, 19(3). https://doi.org/10.3390/ijerph19031284.

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Published

2026-04-07

How to Cite

Rahayu, N. D., Haryanto, J., & Sari, D. W. (2026). Psychological and Organizational Determinants of Healthcare Workers’ Retention in Geriatric Care: A Systematic Review. Indonesian Journal of Global Health Research, 8(2), 989–1002. https://doi.org/10.37287/ijghr.v8i2.710

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