Fear of Future Workplace Violence Tied to Burnout and Turnover Intent in Emergency Medical Technicians

Emergency medical technicians who fear future violence at work are more likely to report burnout and to consider leaving their jobs, according to a cross-sectional study of 340 EMTs working in the Ardabil emergency medical service in Iran. The research, published in BMC Psychology, examined how the anticipation of workplace violence relates to two persistent problems in emergency medical services: burnout among staff and the intention to quit. The authors report a positive and statistically significant relationship between fear of future workplace violence, burnout, and turnover intention, with statistical significance assumed at p values below 0.05.

The study was conducted between September 2022 and June 2023 and used three validated instruments. Fear of future workplace violence was measured with the Fear of Future Violence at Work Scale, burnout was assessed with the Maslach Burnout Inventory, and turnover intention was captured with the Turnover Intention Inventory. This design allowed the researchers to quantify each construct separately and then test the associations among them in a single sample of working technicians.

The statistical picture that emerged was consistent across the three variables. Fear of future workplace violence rose in tandem with both burnout and the intention to leave. The authors conclude that fear of future workplace violence plays a critical role in burnout and turnover intention among EMTs, and they position it as an occupational concern in its own right rather than merely a byproduct of isolated violent incidents.

Beyond the central association, the analysis identified demographic and occupational factors linked to each outcome. Burnout was positively correlated with work experience, educational level, occupational field, marital status, and previous experience of violence. Turnover intention was linked to age, work experience, occupational field, and violence experience.

Fear of future workplace violence itself was significantly associated with age, work experience, educational level, occupational field, and previous violence experience. The repeated appearance of prior violence experience across all three measures is a notable pattern in the results. Technicians who had already experienced violence at work showed higher levels on burnout, turnover intention, and fear of future violence alike, indicating that past incidents coincide with a heavier burden of exhaustion, exit thinking, and heightened expectation of future harm within this sample.

As a cross-sectional descriptive study, it measured fear, burnout, and turnover intention at a single point in time, so the findings demonstrate association rather than causation. Fear may accompany burnout and quitting intentions, but exhausted or exit-minded technicians may also appraise future threats more negatively, and unmeasured factors could underlie all three outcomes. The sample was also drawn from a single provincial emergency medical service, which limits how far the results can be generalized to other regions, health systems, or countries.

The 340 participants represent the Ardabil emergency medical service workforce during the study window, and the multivariate analysis of variance approach used by the team reflects the study's descriptive, associational aims rather than any test of an intervention. Because the anticipation of violence is entangled with exhaustion and retention in their data, they conclude that emergency administrators and healthcare policymakers should prioritize strategies to manage workplace violence and provide support for emergency medical technicians. In their reading, addressing violence and the fear it leaves behind belongs at the center of efforts to sustain the emergency medical workforce.

The study adds to the evidence base on working conditions in emergency medical services by showing that what technicians expect to happen in the future, and not only what has happened to them in the past, is measurable and meaningfully associated with how burned out they feel and whether they intend to stay in the profession. For services struggling with retention, the findings suggest that fear of future violence is a variable worth monitoring alongside workload and staffing, while any causal claims or intervention effects will require longitudinal and experimental research that this cross-sectional design could not provide.

Subject of Research: Associations between fear of future workplace violence, burnout, and turnover intention among emergency medical technicians

Article Title: The association between fear of future workplace violence with burnout and turnover intention among emergency medical technicians: a cross-sectional study

Article References: Golamreza, S., Mohammad-Ali, M., & Saeid, M. (2026). The association between fear of future workplace violence with burnout and turnover intention among emergency medical technicians: a cross-sectional study. BMC Psychology. https://doi.org/10.1186/s40359-026-05499-x

Image Credits: AI Generated

DOI: 10.1186/s40359-026-05499-x

Keywords: emergency medical technicians, workplace violence, burnout, turnover intention, cross-sectional study, occupational health, emergency medical services, Maslach Burnout Inventory, fear of future violence, health workforce retention, Iran, Ardabil