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Review 1: "Mediating Effect of Work Stress in the Relationship Between Fear of COVID-19 and Nurse Organizational and Professional Turnover Intentions"

Published onApr 24, 2023
Review 1: "Mediating Effect of Work Stress in the Relationship Between Fear of COVID-19 and Nurse Organizational and Professional Turnover Intentions"
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key-enterThis Pub is a Review of
Mediating effect of work stress in the relationship between fear of COVID-19 and nurses’ organizational and professional turnover intentions

Nursing is one of the most stressful and high-risk professions. It is important to identify the psychological problems experienced by nurses during the COVID-19 pandemic and examine the relationship between these problems to devise measures that can properly address them. This study examined mediating effect of work stress in the relationship between fear of COVID-19 and nurses’ organizational and professional turnover intentions. Using a cross-sectional research design, this study was conducted on 486 nurses working in seven hospitals in Turkey. The mean age of the participants was 35.24±6.81 and 59.9% of them were women. The Fear of COVID-19 Scale, the General Work Stress Scale, and the Turnover Intention Scale were used to collect data. A mediation model showed that fear of COVID-19 was positively associated with work stress and organizational and professional turnover intentions. The model also revealed that work stress was positively associated with organizational and professional turnover intentions. Furthermore, the results demonstrated that fear of COVID-19 did not only have a direct effect on organizational and professional turnover intentions but also had an indirect effect on it via increased work stress. Findings improve our understanding of the role of work stress in the relationship between fear of COVID-19 and organizational and professional turnover intentions. The findings are fruitful for tailoring and implementing intervention programs to reduce the adverse psychological impacts of COVID-19 on nurses.

RR:C19 Evidence Scale rating by reviewer:

  • Potentially informative. The main claims made are not strongly justified by the methods and data, but may yield some insight. The results and conclusions of the study may resemble those from the hypothetical ideal study, but there is substantial room for doubt. Decision-makers should consider this evidence only with a thorough understanding of its weaknesses, alongside other evidence and theory. Decision-makers should not consider this actionable, unless the weaknesses are clearly understood and there is other theory and evidence to further support it.



This manuscript was conducted to examine whether the work stress of nurses was a mediator for the fear of Covid-19 and the intention to leave the organizational and the profession. It was conducted with 486 nurses from 7 hospitals. The manuscript contains important results in terms of showing the effects of nurses’ fear of Covid-19, work stress and intention to leave the organization and profession during the Covid-19 pandemic process. It has been shown that nurses’ fear of Covid-19 has a direct and indirect effect on job stress and on intention to leave the organization and profession. However, the study has important shortcomings, especially in terms of method. Suggestions for improvement and questions regarding the article are outlined below.

To begin, even though the focus of the study is nurses, the fact that there is no nurse researcher among the researchers is a disadvantageous situation in terms of the research plan and interpretation of the results. Likewise, the characteristics of the hospitals included in the sample are quite different. Therefore, choosing a sample without any sampling method threatens the reliability of the study results.

Furthermore, data collection dates should be written in the method section. And, as understood from the ethics committee and permission dates, the data was collected in the first year of the pandemic process. In this case, the precautions taken in terms of Covid-19 should be explained in interaction with the participants. In addition, considering that the participants were on active duty in this process, it should be stated how much time it took for the nurses to fill in the questionnaire. Also in regard to their methods, the “Fear of Covid-19 Scale” was developed in a normal population and its validity and reliability were established. Nurses are at much greater risk for Covid-19 than a normal population. For this reason, it is necessary to use a specific measurement tool for nurses.

In the “findings” section, there are many results that are not referenced in the title, purpose, and methods of the study — including such pieces in these earlier sections of the paper would have made the preprint more cohesive, with a clear purpose. For example, how does looking at differences according to working hours align with the purpose of the work? There are additional inconsistencies regarding the interpretation of Table 2, where there is the expression, “the female participants’ mean organizational turnover intention score was higher compared to that of the male participants, with difference between these scores being statistically significant,” (p<0.05). However, the p-value in Table 1 is 0.680. The table and its interpretation are not consistent.

Finally, the discussion section should be focused on the variables of this study. For this reason, this section should be synthesized and organized focusing on the variables in the study. Limitations of the study should also be stated in the discussion section, and, the “implications” section should be geared towards real problems — solutions such as group therapies will not work unless the problems such as overworking, which are also included in the findings of the study, are resolved. In this section, the result of the researchers’ distance from the field is seen more strikingly. Last but certainly not least, spelling errors must be corrected prior to publication.

Ultimately, while the piece is potentially informative, authors must refine its inconsistencies and ensure each of their results is explained in relation to the preprint and nursing population as a whole.

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