Journal List > J Korean Acad Nurs > v.49(3) > 1129520

Na and Park: The Effect of Nurse's Emotional Labor on Turnover Intention: Mediation Effect of Burnout and Moderated Mediation Effect of Authentic Leadership



To investigate the effect of nurses’ emotional labor on their turnover intention that was mediated by burnout and to examine the moderated mediation effect of authentic leadership.


A total of 227 nurses working at two general hospitals in Seoul were recruited from March 21 to May 6 in 2016. Emotional labor including surface acting and deep acting; burnout factors such as emotional exhaustion and personal accomplishment; and turnover intention were assessed. The data were analyzed using SPSS 22.0 and SPSS PROCESS macro.


Surface acting significantly increased emotional exhaustion and reduced personal accomplishment. Deep acting significantly increased personal accomplishment. Emotional exhaustion significantly increased turnover intention. Conversely, personal accomplishment significantly reduced turnover intention. Surface acting had an indirect effect on turnover intention that was mediated by emotional exhaustion. Deep acting had an indirect effect on turnover intention that was mediated by personal accomplishment. Authentic leadership had a moderated mediation effect on the relationship between surface acting and turnover intention that was mediated by emotional exhaustion.


The findings of this study indicate that the establishment of strong authentic leadership by head nurses would help nurses reduce their burnout and turnover intention. Conducting intervention studies would be also important to promote better work environments that would enable nurses to fortify the positive aspect of emotional labor and to reduce their burnout levels.


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Figure 1.
Conceptual framework of this study.
Figure 2.
Moderated mediation model testing the indirect effect of emotional labor on turnover intention through burnout moderated by authentic leadership.
Figure 3.
Conditional effect of surface acting on turnover intention mediated by emotional exhaustion according to authentic leadership level.
Table 1.
General Characteristics of Participants (N=227)
Variable Category n (%) M SD
Gender Male 2 (0.9)
Female 225 (99.1)
Age (yr) ≤26 59 (26.0) 32.22 6.53
27~30 53 (23.3)
31~36 56 (24.7)
≥37 59 (26.0)
Marital status Single 124 (54.6)
Married 103 (45.4)
Religion Yes 100 (44.1)
No 127 (55.9)
Education Diploma 31 (13.7)
≥Bachelor’s 196 (86.3)
Total career (yr) 1~3 58 (25.6) 9.11 6.45
4~8 60 (26.4)
9~13 51 (22.4)
≥14 58 (25.6)
Shift 3 shifts 185 (81.5)
D or E shift(s) 13 (5.7)
Night shift 4 (1.8)
D shift 25 (11.0)
Department Medicine 64 (28.2)
Surgical 72 (31.7)
Outpatient 11 (4.8)
Special unit 31 (13.7)
Oriental medicine 44 (19.4)
VIP ward 5 (2.2)

D=Day; E=Evening; M=Mean; SD=Standard Deviation.

Table 2.
Means, Standard Deviations, and Correlations among Turnover Intention, Burnout, Emotional Labor and Authentic Leadership (N=227)
Variable M SD 1 2 3 4 5 6
1. Turnover intention 4.10 1.07          
2. Emotional exhaustion 3.57 0.59 .51***        
3. Personal accomplishment 3.38 0.43 -.24*** -.23**      
4. Surface acting 3.45 0.73 .11 .37*** -.17*    
5. Deep acting 2.91 0.70 .00 .08 .23** .18**  
6. Authentic leadership 2.22 0.68 -.11 -.15* .14* -.05 .14*
7. Career 9.11 6.45 -.48*** -.18** .18** -.03 .05 .13*

M=Mean; SD=Standard Deviation; Emotional labor includes surface acting and deep acting; Burnout includes emotional exhaustion and personal accomplishment.

* p<.05; **p<.01; ***p<.001.

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