Workplace interpersonal relationships and turnover intentions among care workers in older adult care facilities: a mediation analysis comparing direct and mediated effects via psychological distress

Abstract Background This study aimed to investigate the relationship between workplace interpersonal relationships, psychological distress, and turnover intentions among care workers working in older adult care facilities. Methods An anonymous online survey among 811 care workers in Tottori Prefecture, Japan, was conducted between November and December 2023. The data were collected using the Workplace Interpersonal Problems Scale for care workers (WIPS), the K6 scale, the Turnover Intention Scale and basic attributes. Responses were obtained from 254 participants with a response rate of 31.3%. Results The results of the mediation analysis for the WIPS subscale which was adjusted for basic attributes show that insufficient communication (direct effect, 0.319; mediated effect, 0.194), a sense of unfair workload (direct effect, β = 0.314; mediated effect, β = 0.190), and different attitudes to care work (direct effect, β = 0.278; mediated effect, β = 0.204) had stronger direct effect on turnover intention, whereas difficulty guiding subordinates/new staff (direct effect, β = 0.207; mediated effect, β = 0.219) and labeling (direct effect, β = 0.198; mediated effect, β = 0.211) had slightly stronger mediated effect on turnover intentions through psychological distress. For bullying (direct effect, β = 0.207; mediated effect, β = 0.204), the direct and mediated effects on turnover intention were nearly equal. Conclusions This study revealed that some workplace interpersonal problems have a stronger direct effect on turnover intentions, whereas others have a stronger mediating effect on turnover intentions through psychological distress. Workplace interpersonal problems are predictors of turnover intentions among care workers working in elderly care facilities, and different workplace interpersonal problems should be targeted for intervention to reduce turnover intentions.