Explaining Turnover Intention among Physicians in Egyptian Public Hospitals: The Impact of Work-Life Balance and The Mediating Role of Job Satisfaction
Author(s)
Reham Gamal Mohamed ElSayed Heikal , Professor: Safaa Shaaban ,
Download Full PDF Pages: 11-25 | Views: 10 | Downloads: 2 | DOI: 10.5281/zenodo.19681485
Abstract
Purpose: Even though employee turnover intention is a major problem for businesses worldwide, physicians at Egyptian public hospitals have not received enough attention. As a result, this study examines how work-life balance affects turnover intention while simultaneously examining the role that job satisfaction plays as a mediating factor.
Methodology: An online survey distributed through social media sites was used in a quantitative, cross-sectional approach. 566 physicians working in Egyptian public hospitals made up the study sample. The data was examined using SPSS and AMOS to determine whether the suggested associations were accurate and whether any direct or indirect impacts existed.
Findings: The results indicate that physicians’ likelihood of quitting their job is significantly impacted negatively by work-life balance. Work-life balance also improves job satisfaction, which in turn reduces the intention to leave. Furthermore, the association between work-life balance and turnover intention was found to be somewhat mediated by job satisfaction. Therefore, by increasing employee satisfaction, work-life balance reduces turnover intention both directly and indirectly.
Implications: These findings highlight the need for public healthcare organizations to support work-life balance programs since doing so can increase physician satisfaction and reduce their likelihood of quitting.
Future Research: To improve understanding of workforce dynamics in Egypt, future studies may build on current one by including more healthcare professionals and examining more organizational aspects.
Keywords
Work–Life Balance; Job Satisfaction; Turnover Intention; Physicians; Egypt
References
1. Adriano, Judite & Callaghan, Chris. (2020). Work-life balance, job satisfaction and retention: Turnover intentions of professionals in part-time study. South African Journal of Economic and Management Sciences. 23. 1-12. 10.4102/sajems.v23i1.3028.
2. Agha, Kakul & Azmi, Feza & Khan, Sami. (2017). Work-Life Balance: Scale Development and Validation.
3. Akelois, Adonia. (2025). The Influence of Work-Life Balance on Turnover Intention is Mediated by Job Satisfaction at KAP in Indonesia. Journal of Information Systems Engineering and Management, 10. 199-212. 10.52783/jisem.v10i6s.714.
4. Al Maqbali, M., Al Shehhi, M., Al Hosani, F., & Hughes, C. (2026). Factors influencing job satisfaction and turnover intention among nurses in the UAE. PloS one, 21(3), e0344434. https://doi.org/10.1371/journal.pone.0344434
5. Aman-Ullah, Attia & Ibrahim, Hadziroh & Aziz, Azelin & Mehmood, Waqas. (2022). Balancing is a necessity not leisure: a study on work-life balance witnessing healthcare sector of Pakistan. Asia-Pacific Journal of Business Administration, 16. 10.1108/APJBA-09-2020-0338.
6. Arunika, & Kottawatta, Hemantha. (2015). The Effect of Work Life Balance on Employee Job Satisfaction among Non Executives in the Public Banking Sector in Colombo District. HRM Scintilla: Human Resource Management Journal, 03, 60–71. https://doi.org/10.31357/hrmj.v3i1.2936
7. Avanzi, L., Fraccaroli, F., Sarchielli, G., Ullrich, J. and van Dick, R. (2014). Staying or leaving: a combined social identity and social exchange approach to predicting employee turnover intentions. International Journal of Productivity and Performance Management, Vol. 63 No. 3, pp. 272-289
8. Azmi, M., Hanafi, A., Adam, M. (2021). Mediating role of job satisfaction in the effect of work-life balance and work passion on turnover intention. Junior Scientific Researcher, Vol VII, No. 1, pp. 33-48.
9. Baron, Reuben & Kenny, David. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51. 1173-1182. 10.1037//0022-3514.51.6.1173.
10. Bothma, C. F. C., & Roodt, G. (2013). The validation of the turnover intention scale. SA Journal of Human Resource Management, 11(1), 1-12. doi:10.4102/sajhrm.v12i1.524.
11. Brayfield AH, Rothe HF. (1951). An index of job satisfaction. J Appl Psychol. 1951; 35: 307–311. https://doi. org/10.1037/h0055617.
12. Caecilia Setya Budi Wahyuni, Mochammad Al Musadieq, Arik Prasetya, and Zainul Arifin, (2025). The Impact of Work-life Balance on Job Satisfaction Through Gender as a Moderating Variable: A Literature Review in Brawijaya International Conference on Business Administration. Taxation, and Tourism, KnE Social Sciences, pages 166–180. DOI 10.18502/kss.v10i13.18951.
13. Cao, J., Jia, Z., Zhu, C., Li, Z., Liu, H., Li, F., & Li, J. (2021). Nurses' turnover intention and associated factors in general hospitals in China: A cross-sectional study. Journal of Nursing Management, 29(6), 1613-1622.
14. Cherif, F. (2020). The role of human resource management practices and employee job satisfaction in predicting organizational commitment in Saudi Arabian banking sector. International Journal of Sociology and Social Policy, 40(7/8), 529–541.
15. Costello, AB & Osborne, Jason. (2005). Best Practices in Exploratory Factor Analysis: Four Recommendations for Getting the Most From Your Analysis. Practical Assessment, Research & Evaluation. 10. 1-9.
16. Diakos, G., Stamatakis, E. & Leivaditaki, A. (2023). Job satisfaction and turnover intention among greek healthcare professionals during the covid-19 pandemic. BMC Health Services Research, 23 (1), 107. doi: 10.1186/s12913-022-07551-.
17. Eisa NM, El-Tabakh MAM, Kamal NM, Gharbia SM, Samir MM, Syed W, Al-Rawi MBA, Warda AEA, Refaee ASH. (2025). Burnout syndrome and healthy lifestyle among Egyptian physicians: A cross-sectional study. PLoS One. 2025 Apr 18;20(4):e0320146. doi: 10.1371/journal.pone.0320146. PMID: 40249740; PMCID: PMC12007710.
18. ElBeheiry, M. (2025). Determinants of Physicians' Brain Drain in Egypt. [Master's Thesis, the American University in Cairo]. AUC Knowledge Fountain. https://fount.aucegypt.edu/etds/2420.
19. El-Kalamawie, H., Salem, M., & El-darwish, M. (2021). Healthcare workforce in egypt: Current situation and future challenges. Journal of Healthcare Communications, 6 (1), 1-12. doi: 10.4172/2472-1654.1000198.
20. Fisher-McAuley, Gwenith, J. Stanton, J. Jolton, and James Gavin. (2003). Modelling the Relationship between Work-Life Balance and Organizational Outcomes. In Annual Conference of the Society for Industrial-Organizational Psychology. Orlando, pp. 1-26.
21. Gautam, Prakash & Gautam, Dhruba & Bhetuwal, Rakshya. (2024). Work-life balance, job satisfaction and turnover intentions among nurses Turnover intentions among nurses. 10.1108/IJOA-09-2023-4002.
22. George, J.B. and Poluru, N.V. (2024). Exploring the impact of flexible work arrangements on turnover intention: the mediating role of job satisfaction and the moderating effect of perceived supervisory support. Journal of Accounting, Business and Management (JABM), Vol. 32 No. 1, pp. 100-123. doi: 10.31966/jabminternational.v32i1.1467.
23. Harun, Ifrah. (2020). Factors Affecting Turnover Intention in Public Healthcare Workforce: A Conceptual Study. Asian Journal of Research in Business and Management, [S.l.], v. 2, n. 2, p. 76-85.
24. Hashim Hassan Alsheikhy, Rajeh Ahmed Alhayli, Ibrahim Ali Ibrahim Aqeel, Ali Hamod Aseeri, Ibrahim Awad Alhelaly (2022). The Challenges Healthcare Professionals Face in Maintaining a Healthy Work-Life Balance. International Journal of Innovative Research in Engineering & Multidisciplinary Physical Sciences | ISSN: 2349-7300.
25. Hatcher, L. (1994). A Step-by-Step Approach to Using the SAS System for Factor Analysis and Structural Equation Modeling. SAS Institute, Inc., Cary.
26. Hayman, Jeremy. (2005). Psychometric Assessment of an Instrument Designed to Measure Work- Life Balance. Research and Practice in Human Resource Management 13, no. 1: 85-91.
27. Hui, Sim & Ping, Ki & Fung, Chorng Yuan. (2023). The Relationship between Work-Life Balance, Job Satisfaction, and Turnover Intention among Accounting Personnel in Public Accounting Firms. Journal of Cognitive Sciences and Human Development, 9. 63-88. 10.33736/jcshd.5795.2023.
28. Jacobs, E. J., & Roodt, G. (2008). Organisational culture of hospitals to predict turnover intentions of professional nurses. Journal of Interdisciplinary Health Sciences, 13(1), 63-78. doi:10.4102/hsag.v.13i1.258.
29. Ji Y, Hu W, Xu D, Chai F, Wang Y, Xu C and Li X (2026). A study on the relationship between work stress and turnover intentions among critical care nurses: mediating roles of job satisfaction and burnout. Front. Public Health 14:1744177. doi: 10.3389/fpubh.2026.1744177.
30. Judge TA, Klinger R. (2008). Job satisfaction: Subjective well-being at work. In: Eid M, Larsen RJ, editors. The science of subjective well-being. New York, NY: Guilford Press; 2008. pp. 393–413.
31. Kerdpitak, C. and Jermsittiparsert, K. (2020). The effects of workplace stress, work-life balance on turnover intention: an empirical evidence from pharmaceutical industry in Thailand. Systematic Reviews in Pharmacy, Vol. 11 No. 2, pp. 586-594.
32. Khan, Jaffer & Raman, Alamelu & Sambamoorthy, Nithya & Prashanth, Kanniga. (2023). Research Methodology (Methods, Approaches And Techniques)”. 10.59646/rmmethods/040.
33. Lai Kun Tong, Yue Yi Li, Yong Bing Liu, Mu Rui Zheng, Guang Lei Fu, Mio Leng Au (2025). Validation of the short index of job satisfaction in Chinese nurses: classical test theory and item response theory. International Journal of Nursing Studies Advances 8 (2025) 100321. https://doi.org/10.1016/j.ijnsa.2025.100321
34. Lebang, F. A., & Ardiyanti, N. (2021). The effect of work-life balance and work stress on turnover intention with job satisfaction as a mediator at anti-corruption institution in Indonesia. In 5th Global Conference on Business, Management and Entrepreneurship (GCBME 2020) (pp. 638-648).
35. Liou, S.-R. (2009). Nurses' intention to leave: critically analyses the theory of reasoned action and organizational commitment model. Journal of Nursing Management, 17: 92-99. https://doi.org/10.1111/j.1365-2834.2008.00873.x.
36. Magdy, Ahmed & Elhosseiny, Islam. (2023). Human Resource Management in the Egyptian Healthcare System, Physician Immigration. 10.21203/rs.3.rs-3132565/v1.
37. Martin, A., & Roodt, G. (2008). Perceptions of organisational commitment, job satisfaction and turnover intentions in a post-merger South African tertiary institution. SA Journal of Industrial Psychology, 34(1), 23-31. doi:10.4102/sajip.v34i1.415.
38. Meade AW, Craig SB. (2012). Identifying careless responses in survey data. Psychol Methods. 2012; 17: 437–455. https://doi.org/10.1037/a0028085 PMID: 22506584.
39. Mengmeng, L., Aziz, N. A. A., & Omar, M. K. (2025). Unveiling of Key Factors Influencing Turnover Intention: A Review of Literature. International Journal of Academic Research in Business and Social Sciences, 15(2), 160–168.
40. Nuradilla, Zahra & Sulastiana, Marina & Efi, Fitriana. (2024). Exploring the Impact of Work-Life Balance on Employees: A Systematic Literature Review. International Journal of Psychological Studies. 16. 86-86. 10.5539/ijps.v16n3p86.
41. Nurdin, S. and Rohaeni, H. (2020). Work-life balance and its impact on turnover intention in the millennium: the mediation role of job satisfaction. Journal Konsep Bisnis Dan Manajemen, Vol. 6 No.2, pp. 121-132.
42. Pappas, M.A., Stoller, J.K., Shaker, V., Houser, J., Misra-Hebert, A.D. and Rothberg, M.B. (2022). Estimating the costs of physician turnover in hospital medicine. Journal of Hospital Medicine, Vol. 17 No. 10, pp. 803-808. doi: 10.1002/jhm.12942.
43. Prabhu, S., Thomas, P. & Singh, H.B. (2026). Impact of job stress and work-life balance on turnover intention among Indian healthcare workers. Discov Public Health 23, 140. https://doi.org/10.1186/s12982-026-01426-y.
44. Reni Handayani, Roni Faslah, Maulana Amirul Adha. (2024). The Impact of Work-Life Balance on Turnover Intentions: Exploring the Mediating Role of Job Satisfaction. Journal Pendidikan Ekonomi, Perkantoran, dan Akuntansi E-ISSN: 2722-9750 Volume 5 No. 2.
45. Riley, D., (2006). Turnover intentions: The mediation effects of job satisfaction, affective commitment and continuance commitment. PhD thesis, University of Waikato, Hamilton, New Zealand.
46. Scanlan, J.N. and Still, M. (2019). Relationships between burnout, turnover intention, job satisfaction, job demands and job resources for mental health personnel in an Australian mental health service. BMC Health Services Research, Vol. 19 No. 1, pp. 1-11.
47. Scheffler, R.M. and Arnold, D.R. (2021). Projecting shortages and surpluses of doctors and nurses in the Economic Co-operation and Development countries: what looms ahead. Health Economics, Policy and Law, Vol. 14 No. 2, pp. 274-290.
48. Seathu Raman, S.S., McDonnell, A. and Beck, M. (2024). Hospital doctor turnover and retention: a systematic review and new research pathway. Journal of Health Organization and Management, Vol. 38 No. 9, pp. 45-71. https://doi.org/10.1108/JHOM-04-2023-0129.
49. Shibru, B. (2022). Impact of employee turnover on organizational performance: the case of Bekas Chemicals Plc., Ethiopia. Journal of Material Sciences & Manfacturing Research, 1–7. https://doi.org/10.47363/jmsmr/2022(3)125.
50. Silaban, H., & Margaretha, M. (2021). The Impact Work-Life Balance toward Job Satisfaction and Employee Retention: Study of Millennial Employees in Bandung City, Indonesia. International Journal of Innovation and Economic Development, 7(3), 18–26. https://doi.org/10.18775/ijied.1849-7551-7020.2015.73.2002.
51. Sinval J, Maroˆco J (2020). Short Index of Job Satisfaction: Validity evidence from Portugal and Brazil. PLoS ONE 15(4): e0231474. https://doi. org/10.1371/journal.pone.0231474.
52. Sobia, S., Farooq, E. A. C., & Faryal, B. (2011). Impact of Work Life Balance on Employee Job Satisfaction in Private Banking Sector of Karachi. Journal of Management and Social Sciences, 7(2), 8–15.
53. Suganda, U. K. (2022). Reducing turnover intention: The mediating role of work-life balance and organizational commitment. International Journal of Business Ecosystem & Strategy, 4(3), 01–12. https://doi.org/10.36096/ijbes.v4i3.344.
54. Sun, Y., Wang, W., Yan, F., Xie, X., Cai, M., Xu, F., Qian, Y., Xiao, Y., Xu, C., & Zhao, W. (2025). Related factors of turnover intention among general practitioners: a cross-sectional study in 6 provinces of China. BMC primary care, 26(1), 37. https://doi.org/10.1186/s12875-025-02728-x.
55. Talukder, A.M.H. (2018). Supervisor support and organizational commitment: the role of work– family conflict, job satisfaction, and work–life balance. Journal of Employment Counseling, Vol. 56 No. 3, pp. 98-116.
56. Tariq, S. Asad, A. Majeed, and U. Fahim.(2021). Work-family conflict, psychological empowerment, and turnover intentions among married female doctors. Bangladesh Journal of Medical Science, vol. 20, no. 4, pp. 855 863. doi: 10.3329/bjms.v20i4.54145.
57. Tawfik DS, Shanafelt TD, Dyrbye LN, et al. (2021). Personal and Professional Factors Associated With Work-Life Integration Among US Physicians. JAMA Netw Open, 2021;4(5):e2111575. doi:10.1001/jamanetworkopen.2021.11575.
58. Upadianti, L. P. S., & Surya, I. B. K. (2025). Job stress and work-life balance on turnover intention: The mediating role of job satisfaction. International Research Journal of Management, IT and Social Sciences, 12(4), 135–150. https://doi.org/10.21744/irjmis.v12n4.2520.
59. Wenyan, Y., Arshad, M. A., & Chenshu, Y. (2024). The Impact of Human Resource Management Practices on Turnover Intention: A Literature Review. International Journal of Academic Research in Economics and Management and Sciences, 13(1), 254–271.
60. Worthington, Roger & Whittaker, Tiffany. (2006). Scale development research: A content analysis and recommendations for best practices. The Counseling Psychologist, 34(6), 806–838. https://doi.org/10.1177/0011000006288127
61. Yu Chenshu, Mohd Anuar bin Arshad, Yao Wenyan. (2024). A Literature Review on The Effects of Work-Life Balance on The Turnover Tendency of Employees. International Journal of Academic Research in Economics and Management Sciences, Vol. 13, No. 1, E-ISSN: 2226-3624. http://dx.doi.org/10.6007/IJAREMS/v13-i1/21028.
Websites
· Tackling medical attrition in the UK’s health services (British Medical Association Report, 2024).
Cite this Article: