INTENTION TO LEAVE AMONG COMMUNITY, HOME CARE AND PRIMARY HEALTH CARE NURSES: A SCOPING REVIEW

Abstract

Introduction: Intention to leave (ITL) is a relevant predictor of nurse turnover and workforce instability. While extensively studied in hospital settings, evidence in community, home care, and primary health care remains limited despite the growing relevance of these services. Objective: To map the available evidence on ITL among nurses working in community, home care, and primary health care settings and to identify associated factors. Materials and Methods: A scoping review was conducted and reported according to the PRISMA-ScR framework. Six electronic databases were searched, applying a publication-date restriction from January 2016 to May 2026. Studies focusing on ITL among nurses working in out-of-hospital settings were included and analyzed using a narrative synthesis approach. Results: Thirty studies were included. Findings indicate that ITL is influenced by a complex interaction of factors, which can be grouped into two main domains: management factors (e.g., leadership, organizational support, professional autonomy) and context factors (e.g., workload, burnout, moral distress, work environment characteristics). Conclusion: These findings suggest that ITL emerges when job demands exceed available resources, in line with the Job Demands–Resources model. Unlike evidence derived predominantly from hospital settings, this review suggests that intention to leave in community and home care is shaped not only by common organizational factors but also by setting-specific characteristics, including the dual role of professional autonomy, professional isolation, and delegation practices. These findings extend current evidence by providing a context-specific framework for interpreting ITL in out-of-hospital nursing services.