Quality of the Healthy Work Environment and Retention Intention among Nurses in Tertiary Hospitals: Mediating Roles of Need Satisfaction and Work-Life Balance

Abstract

Purpose: This study examined whether need satisfaction and work-life balance mediated the relationship between the quality of the healthy work environment and retention intention among nurses in tertiary hospitals. Methods: Data were collected from 187 nurses with at least one year of clinical experience in tertiary hospitals between March 27 and April 19, 2025. Participants completed a structured self-report questionnaire distributed through online communities. Data were analyzed using IBM SPSS Statistics 26.0, and mediation effects were tested with PROCESS Macro Model 4. Results: The quality of the healthy work environment significantly predicted need satisfaction (β=.43, p<.001), work-life balance (β=.43, p<.001), and retention intention(β=.16, p=.037). Need satisfaction (β=.19, p=.009) and work-life balance (β=.19, p=.008) were also significant predictors of retention intention. The direct effect of work environment quality on retention intention was significant(effect=0.59, 95% confidence interval [CI]: 0.04~1.14), and significant indirect effects were observed through need satisfaction (effect=0.29, 95% CI: 0.05~0.81) and work-life balance (effect=0.30, 95% CI: 0.03~0.60), supporting partial mediation. Conclusion: A higher-quality healthy work environment may be associated with stronger retention intention among nurses, partly through greater need satisfaction and work-life balance. Interventions that strengthen these mediating factors may support nurse retention and sustainable workforce management in tertiary hospitals.