Perceived fulfillment of multilevel psychological contract responsibilities, job burnout, and turnover intention among primary care physicians: a structural equation modeling analysis

Background and objectives: Primary care physicians face substantial occupational mental health challenges, including job burnout and turnover intention. Psychological contract theory conceptualizes employment relationships in terms of perceived reciprocal obligations, while the Job Demands-Resources (JD-R) model provides a complementary framework for understanding how work-related conditions may be associated with burnout. This study examined the structural associations among perceived fulfillment of multilevel psychological contract responsibilities, job burnout dimensions, and turnover intention among primary care physicians.