This conceptual study seeks to establish a detailed framework that explores the relationships among perceived human resource management (PHRM), presenteeism, leader-member exchange (LMX), and employee turnover intention (ETI) in the context of Malaysia's healthcare sector. Drawing on Signalling Theory and Social Exchange Theory, the model suggests that supportive HR practices have a direct and indirect impact on nurses’ behavioural intentions via presenteeism, while the quality of supervisor relationships (LMX) serves as a moderating factor in these effects. The framework highlights that strong LMX relationships can amplify the detrimental effects of PHRM on presenteeism while also mitigating the negative consequences of presenteeism on turnover intentions. This work, while theoretical, lays the groundwork for future empirical validation and presents important insights for healthcare practitioners and policymakers aiming to improve nurse retention and strengthen organisational resilience. This study enhances theoretical understanding by combining essential organisational and relational elements, while also providing practical insights for developing targeted strategies to promote sustainable workforce management in Malaysia.
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