Retention and Motivational Factors Associated with Turnover Intention Among Nurses in Public and Private Hospitals of Peshawar, Pakistan: A Cross-Sectional Study

Objective: To compare retention and motivational factors associated with turnover intention among nurses working in public and private hospitals in Peshawar, Pakistan Methods: A comparative cross-sectional study was conducted among 240 registered nurses from Northwest General Hospital (private) and Khyber Teaching Hospital (public). Participants were recruited using a non-probability purposive sampling technique. Data were collected using a validated questionnaire measuring turnover intention (push factors) and retention motivation (pull factors), including work environment, remuneration and career development, supervision, autonomy, organizational commitment, and peer relationships. Independent-samples t-tests were used to compare hospital groups, paired-samples t-tests to compare push and pull factor scores, and the Chi-square test to examine the association between educational status and retention. A p-value < 0.05 was considered statistically significant. Results: The mean age of participants was 28.15 years. Most nurses were younger than 30 years (81.3%), female (60.0%), and had less than three years of work experience (70.0%). Nurses working in the private hospital reported significantly higher turnover intention scores than those in the public hospital (8.95 ± 2.70 vs. 7.44 ± 3.74; p < 0.001). Retention motivation scores (163.41 ± 21.32 vs. 161.74 ± 21.09; p = 0.540) and overall scores (169.50 ± 26.53 vs. 168.75 ± 20.45; p = 0.804) were comparable between hospitals. Across all participants, retention motivation scores were higher than turnover intention scores (3.34 ± 0.51 vs. 2.73 ± 1.08; mean difference = 0.61; p < 0.001). Educational status was not associated with retention level (p = 0.096). Conclusion: Turnover intention was higher among nurses employed in the private hospital, whereas retention motivation was similar in both hospital settings. The findings indicate that workplace conditions, supervision, remuneration, autonomy, and professional relationships remain central to retaining the nursing workforce.