Abstract
BACKGROUND: Nurse shortage and workforce turnover have become critical issues in the global public health sector, recognized internationally as priority concerns. This challenge is particularly prominent in China, where the dual pressures of nurse shortage and high turnover are more acute. Optimizing nursing management processes and creating a highly supportive work environment can effectively alleviate the psychological resource depletion and reduced job satisfaction caused by stress among nurses, thereby lowering their turnover intention. However, research on how illegitimate tasks influence the turnover intention of Chinese nurses remains scarce, and the mediating mechanism of psychological contract breach in this relationship lacks sufficient context-specific verification. OBJECTIVE: This study aims to explore the direct relationships among illegitimate tasks, psychological contract breach, and turnover intention among Chinese clinical nurses, and specifically examine the mediating role of psychological contract breach in the relationship between illegitimate tasks and turnover intention among nurses. METHODS: A cross-sectional study design was employed. From March 2024 to May 2025, a convenience sampling method was used to select 516 clinical nurses from Sichuan Province for a survey. The survey included a demographic information questionnaire, the Illegitimate Tasks Scale, the Psychological Contract Breach Scale, and the Turnover Intention Scale. RESULTS: The results showed that the score of turnover intention among clinical nurses was (13.14 ± 4.15), with 71 nurses (13.7%) having a very high turnover intention. The score of psychological contract breach was (55.79 ± 15.50), and the score of illegitimate tasks was (29.06 ± 8.69). Correlation analysis revealed that the total score of illegitimate tasks and its dimensions were positively correlated with the total score of psychological contract breach and its dimensions (r = 0.401-0.623, p < 0.01), as well as with the total score of turnover intention and its dimensions (r = 0.446-0.495, p < 0.01). The total score of psychological contract breach and its dimensions were also positively correlated with the total score of turnover intention and its dimensions (r = 0.439-0.733, p < 0.01). Mediating effect analysis indicated that psychological contract breach played a significant mediating role between illegitimate tasks and turnover intention, with a mediating effect value of 0.153, accounting for 64.8% of the total effect. CONCLUSION: This study confirms that psychological contract breach mediates the relationship between illegitimate tasks and turnover intention among nurses. Reducing psychological contract breach through interventions that decrease illegitimate tasks can effectively lower nurses' turnover intention. Specific measures include creating a supportive work environment, establishing a sound communication mechanism, and fostering a sense of professional mission.