Introduction
The stability of healthcare personnel is determined by several factors, with social determinants also playing a significant role, influencing individuals' ability to function effectively in an interpersonal environment. Social characteristics represent important psychological resources involved in coping with work stress, reducing tension, and preventing emotional exhaustion in nursing practice. Social competence plays a fundamental role in the provision of nursing care. Healthcare workers with a higher level of social competencies provide more empathetic and patient-oriented care, which is reflected in higher patient satisfaction and better health outcomes (Henriksen, Hansen, Wøien, Tønnessen, 2021). At the same time, it enables them to resolve conflict situations more effectively, participate in teamwork, and provide emotional support to patients and their families (Hardie et al., 2021).
If the work environment of nurses is characterized by increased levels of stress, conflict, and demanding interpersonal requirements, professional satisfaction is disrupted, which subsequently increases the risk of turnover – whether in the form of mobility between workplaces or leaving the healthcare system. Analyses focused on the development of the number of healthcare workers in the Slovak Republic point to an expected deficit in these professions. According to data from the Council for Budget Responsibility, after 2035, a significant decline in the number of nurses will begin to manifest due to the retirement of a numerically strong generation, while the incoming generations will not be able to adequately compensate for this deficit. Forecasts suggest that by 2045, the deficit could reach approximately 7,000 nurses, which will have a negative impact on the availability and quality of provided nursing care.
In the conditions of the Slovak Republic, the determinants of nurse turnover include not only organizational factors, such as high workload or staff shortages, but also the quality of interpersonal relationships, the level of communication in the workplace, and overall satisfaction with the work environment (Mozolová, Tupá, 2024). These facts point to the need for a comprehensive approach to managing the work environment, which includes not only material-technical and organizational provisions but also the systematic strengthening of social aspects of work in multidisciplinary teams. Social determinants represent significant intervention potential in the area of stabilizing nursing staff, as they influence not only the subjective experience of work but also nurses' decision-making processes related to remaining in the profession. The nursing profession is among the helping professions, characterized by a high degree of interpersonal interactions. However, the way individuals respond to these situations is not uniform; while some handle them adaptively, others may experience uncertainty, discomfort, or a lack of adequate communication strategies. Frankovský (2010) points out that these differences can be explained by the interaction of factors at the individual and situational levels. At the individual level, this primarily involves personality characteristics, temperament, and the level of social competencies, while situational factors include, for example, the degree of conflict, the emotional tone of the environment, or the subjective perception of threat.
Behavior in interpersonal situations among workers in helping professions is thus the result of a complex interplay of personality and situational variables. Among the significant constructs applied in explaining and predicting this behavior is social intelligence (Birknerová, Frankovský, 2010). In the context of nursing, it is associated with the ability to understand the experiences, thoughts, and behaviors of others, to adequately interpret social situations, and to regulate one's own behavior in accordance with the demands of the interaction. At a global level, the social competence of nurses is considered a significant factor in the quality of healthcare. Empirical findings indicate that nurses with a higher level of social competencies provide more effective care and contribute to higher patient satisfaction (Rodríguez-Pérez et al., 2022). At the same time, they support better teamwork and interprofessional communication, which are essential for patient safety and the optimization of provided care (Vaseghi et al., 2022).
Research Methodology
The aim of the quantitative cross-sectional study was to analyze differences in the level of social competencies of nurses depending on the experience of leaving the workplace. The dimensions of social intelligence (social information processing, social skills, social awareness) and emotional-social characteristics (regulation of social influence, empathy, social irritability) were examined.
The research sample consisted of nurses working in healthcare facilities in Slovakia (predominantly women; most frequently aged 46–55 years), with a significant portion having a university education and working in a two-shift operation.
Standardized instruments TSIS (Silvera et al., 2001) and MESI (Frankovský, Birknerová, 2011), assessed using Likert scales, were used for data collection. Differences between two independent groups were analyzed using the Mann–Whitney U test due to the violation of the normality assumption. Analyses were performed for individual dimensions of the instruments, considering the variables of leaving the workplace, leaving the profession, and going abroad.
Results
Analysis of differences between groups (according to the variable leaving the workplace)
The results showed that in most of the monitored dimensions (social information processing, social skills, social awareness, manipulation, and empathy), no statistically significant differences were identified between the groups (p > 0.05), indicating that these aspects of social functioning are not significantly influenced by the experience of leaving the workplace.
Conversely, a statistically significant difference was found in the dimension of social irritability (p = 0.013). This result indicates that a higher degree of irritability may reflect a reduced tolerance for social stimuli, higher stress load, and potentially poorer emotion regulation in challenging interpersonal situations. Conversely, lower irritability may act protectively in relation to work stability and adaptation. The absence of differences in social skills and empathy suggests that it is not a deficit in social competencies, but rather a regulatory (affective) aspect of social functioning.
Tab. 1 Differences in TSIS and MESI dimensions according to leaving the workplace
| TSIS – social information processing | TSIS – social skills | TSIS – social awareness | MESI - manipulation | MESI - empathy | MESI – social irritability | |
|---|---|---|---|---|---|---|
| Mann-Whitney U | 1117.50 | 1052.00 | 988.50 | 1053.50 | 931.50 | 825.50 |
| Wilcoxon W | 2342.50 | 2180.00 | 2116.50 | 2181.50 | 2059.50 | 1953.50 |
| Z | -0.250 | -0.733 | -1.197 | -0.747 | -1.679 | -2.484 |
| Asymp. Sig. (2-tailed) | 0.803 | 0.463 | 0.231 | 0.455 | 0.093 | 0.013 |
Tab. 2 Detailed differences in TSIS and MESI dimensions according to workplace abandonment
| Workplace abandonment | N | Mean | |
|---|---|---|---|
| TSIS – social information processing | yes | 49 | 47.81 |
| no | 47 | 49.22 | |
| TSIS – social skills | yes | 49 | 50.53 |
| no | 47 | 46.38 | |
| TSIS – social awareness | yes | 49 | 51.83 |
| no | 47 | 45.03 | |
| MESI - manipulation | yes | 49 | 50.50 |
| no | 47 | 46.41 | |
| MESI - empathy | yes | 49 | 52.99 |
| no | 47 | 43.82 | |
| MESI – social irritability | yes | 49 | 55.15 |
| no | 47 | 41.56 |
Analysis of differences between groups (according to the variable profession abandonment)
The results showed statistically significant differences in the dimensions of social intelligence measured by the TSIS instrument, specifically in social information processing (p = 0.046), social skills (p = 0.047), and social awareness (p = 0.029). Conversely, in the dimensions measured by the MESI instrument (manipulation, empathy, social irritability), no significant differences between groups were confirmed (p > 0.05).
The findings suggest that a higher level of social skills may be related to more effective processing of interpersonal situations, while lower social awareness may reduce the degree of attachment to the work environment. The absence of differences in empathy and irritability also indicates that leaving the profession is more associated with cognitive-behavioral aspects of social functioning than with emotional experience.
Tab. 3 Differences in TSIS and MESI dimensions according to profession abandonment
| TSIS – social information processing | TSIS – social skills | TSIS – social awareness | MESI - manipulation | MESI - Empathy | MESI – social irritability | |
|---|---|---|---|---|---|---|
| Mann-Whitney U | 562.50 | 565.00 | 541.00 | 784.00 | 747.50 | 783.50 |
| Wilcoxon W | 3412.50 | 3415.00 | 772.00 | 3634.00 | 978.50 | 3633.50 |
| Z | -1.997 | -1.982 | -2.188 | -0.032 | -0.369 | -0.037 |
| Asymp. Sig. (2-tailed) | 0.046 | 0.047 | 0.029 | 0.974 | 0.712 | 0.971 |
Tab. 4 Detailed differences in TSIS and MESI dimensions according to profession abandonment
| Profession abandonment | N | Mean | |
|---|---|---|---|
| TSIS – social information processing | yes | 21 | 59.21 |
| no | 75 | 45.50 | |
| TSIS – social skills | yes | 21 | 59.10 |
| no | 75 | 45.53 | |
| TSIS – social awareness | yes | 21 | 36.76 |
| no | 75 | 51.79 | |
| MESI - manipulation | yes | 21 | 48.67 |
| no | 75 | 48.45 | |
| MESI - empathy | yes | 21 | 46.60 |
| no | 75 | 49.03 | |
| MESI – social irritability | yes | 75 | 48.45 |
| no | 21 | 59.21 |
Analysis of differences between groups (according to the variable work abroad)
The results did not show statistically significant differences in any of the monitored dimensions of social competencies (p > 0.05), indicating that considering work abroad is not significantly influenced by social or emotional functioning.
The findings point to a rather rational and contextually conditioned decision-making, which may be more determined by external factors such as working conditions, economic opportunities, and the organizational environment. Unlike other forms of turnover, the significant role of cognitive or affective components of social functioning was not confirmed in this case.
Tab. 5 Differences in TSIS and MESI dimensions according to intention to work abroad
| TSIS – social information processing | TSIS – social skills | TSIS – social awareness | MESI - manipulation | MESI - empathy | MESI – social irritability | |
|---|---|---|---|---|---|---|
| Mann-Whitney U | 740.00 | 589.00 | 715.00 | 778.00 | 750.00 | 665.00 |
| Wilcoxon W | 971.00 | 3439.00 | 3565.00 | 1009.00 | 3600.00 | 3515.00 |
| Z | -.422 | -1.769 | -.644 | -.088 | -.346 | -1.129 |
| Asymp. Sig. (2-tailed) | 0.673 | 0.077 | 0.520 | 0.930 | 0.729 | 0.259 |
Discussion
The aim of the study was to analyze social and emotional characteristics in relation to turnover tendencies among nurses, specifically workplace abandonment, profession abandonment, and considering work abroad. The results point to the differentiated nature of these forms of turnover, with individual aspects of social functioning applying differently depending on the type of decision-making about leaving.
In the case of workplace abandonment, social irritability proved to be a significant factor, indicating the importance of affective regulation in the context of work relationships and stress burden. Higher irritability may be related to environmental conflict and lower tolerance for social stimuli, which increases the tendency to leave the workplace. This result is consistent with findings that emphasize the importance of the quality of the organizational environment, leadership, and social climate for retaining healthcare workers (Poeira, Nunes, 2025; Zafar, Alshammari, 2024).
In the case of profession abandonment, on the other hand, the significant role of emotional characteristics was not demonstrated, but differences in the dimensions of social intelligence were identified. A higher level of social information processing and social skills, combined with lower social awareness, suggests a dominant role of cognitive-behavioral aspects of social functioning in deciding to leave the profession. These findings correspond with knowledge about the importance of working conditions, leadership, and recognition for professional satisfaction and nurse retention (Ahn, Choi, 2023; Bäckström et al., 2024).
In the case of considering work abroad, no significant differences in social or emotional characteristics were demonstrated, pointing to the dominance of external factors such as economic conditions, job opportunities, and the quality of the work environment.
Conclusion
The study highlighted the differentiated importance of social competencies in relation to nurses' turnover intentions. While the importance of regulatory (affective) aspects of social functioning was shown for workplace stability, cognitive-behavioral components of social intelligence play a greater role in leaving the profession. In the case of considering work abroad, the significance of social or emotional characteristics was not demonstrated, pointing to the dominance of external and contextual factors.
Interventions aimed at reducing turnover should therefore reflect the specifics of individual forms of departure – from supporting stress management and the quality of interpersonal relationships, through strengthening professional identity, to improving systemic and working conditions in healthcare.
Authors: PhDr. Valéria Parová, PhD. doc. PhDr. Mária Sováriová Soósová, PhD. Pavol Jozef Šafárik University in Košice, Faculty of Medicine, Institute of Nursing
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