Burnout levels among nursing home care workers and its associations with workplace and individual factors: Results from a multicenter cross-sectional study.

Nursing homes face significant challenges due to increasingly complex care needs, and difficulties in recruiting and retaining care workers. High job demands and stressful work conditions contribute to burnout, exacerbating workforce shortages and potentially impacting care quality. This study describes the prevalence of burnout and its association with organizational, work environment, demographic, and intrapersonal factors among nursing home care workers. A secondary analysis was conducted using cross-sectional survey data from the Flanders Nursing Home (FLANH) project, including 1,521 care workers from 25 Flemish nursing homes. Participants included care assistants (43.7%), registered nurses (20.5%), support staff (15.4%), allied health professionals (14.8%), and team leaders (5.7%). Burnout was assessed using the short Burnout Assessment Tool (BAT-12), and associations were analyzed using a multivariable linear mixed model. Results showed that 19.0% of care workers were at risk of burnout. Higher staffing levels (β= -0.017, p = 0.0015), perceived staffing adequacy (β= -0.040, p = 0.0125), role clarity (β= -0.069, p = 0.0017), skill use (β= -0.109, p < 0.0001), and safety climate (β= -0.052, p = 0.0364) were significantly associated with lower burnout. Conversely, greater emotional burden at work (β = 0.085, p < 0.0001) and work-life interference (β = 0.266, p < 0.0001) were related to higher burnout. Older age, and higher self-efficacy, resilience, and optimism, emerged as significant protective factors. This study confirms the importance of adequate staffing and a supportive work environment in mitigating burnout among nursing home care workers. Targeted strategies to improve the work environment and strengthen intrapersonal resources are essential for promoting staff well-being and retention.

Background: Despite its association with patient safety, few studies on missed nursing care have been conducted in nursing homes. We aimed to describe individual and environmental factors in a sample of registered nurses (RNs) reporting missed nursing care in nursing homes, and to explore the association between these factors and missed nursing care.Methods: In the present, multicentre cross-sectional study, 217 RNs from 43 nursing homes in Northern Italy reported all episodes of missed nursing care (ie, any aspect of required care that was omitted or delayed) that occurred in the 20 most dependent residents (according to RNs’ judgement; 860 residents in total) over 3 consecutive days. Multilevel multivariable logistic regression models were used to test possible explanatory factors of missed nursing care (individual, work-related, organisational, and work environment factors), which were entered in a step-wise manner. Results: Younger RNs (P=.026), freelance RNs (P=.046), RNs with a permanent contract (P=.035), and those working in publicly-owned nursing homes reported more episodes of missed nursing care (P<.012). Public ownership (odds ratio [OR]=9.88; 95% CI 2.22–44.03; P=.003), a higher proportion of residents with severe clinical conditions (OR=2.45; 95% CI 1.12–5.37; P=.025), a lower proportion of RNs (OR=2.24; 95% CI 1.10–4.54; P=.026), and perceived lack of time to care for residents (OR=2.33; 95% CI 1.04–5.26; P=.041) were statistically significantly associated with missed nursing care. Conclusion: Factors associated with missed nursing care are similar in hospitals and nursing homes, and include heavy workload and perceived lack of time for care. Because missed nursing care in nursing homes represents tasks performed specifically by RNs, missed nursing care in this setting should be measured in terms of these tasks. An optimal skill mix is crucial to guarantee not only comfort and basic care for nursing home residents, but also good outcomes for residents with severe clinical conditions.

Background: Given the projected shortage of homecare workers, it is important to examine and optimize working conditions in order to keep them in their field of expertise. However, there is limited knowledge about the prevalence of the intention to leave their job and the modifiable factors that contribute to it. Aims: We assessed the prevalence of homecare workers' intention to leave their current job or the homecare sector entirely and the relationship between work environment, i.e., organizational characteristics (e.g., leadership, staffing, teamwork, and predictability) and work context factors, i.e., job characteristics and role definition (e.g., autonomy, overtime, and role clarity) with leaving intentions. Methods: This analysis included data from a national, multicenter, cross-sectional study in Switzerland, conducted from January to September 2021. We included 1898 homecare workers of 85 stratified randomly selected homecare agencies, performing descriptive analyses and logistic multilevel regressions to calculate prevalence and examine associations. Results: Overall, 58.5% of respondents reported at least a slight intention to leave the current job, while 12.6% considered leaving the homecare sector. Leadership was significantly negatively associated to respondents' intentions to leave the current job; predictability and job satisfaction were significantly negatively associated with both leaving intentions. Job satisfaction mediated work environment factors such as staffing. Conclusions: Leadership was one of the most important work environment factors related to intention to leave. Therefore, political decision makers and homecare managers need to lay the foundation to foster development, improvement, and empowerment of leadership roles. Homecare agencies should target improvement efforts based on the effect of overtime and the implementation of predictability and social support in their organization in order to reduce intention to leave and improve job satisfaction. Future studies could focus on deepening our understanding by empowering nurse leaders in creating and sustaining a positive work environment.

Nurses in intensive care units (ICUs) face high levels of stress and emotional challenges, making it essential to understand the factors that influence their professional quality of life (ProQoL). This study aimed to investigate the relationship between work environment factors and ProQoL, particularly focusing on burnout, compassion satisfaction, and secondary traumatic stress, among ICU nurses. The Professional Quality of Life (ProQoL) Scale was used to measure these aspects, with an emphasis on the importance of a supportive work environment for enhancing staff well-being and organizational performance. This cross-sectional study was conducted between March and August 2024, involving 162 ICU nurses from hospitals in the southern West Bank. A stratified random sampling method was employed to ensure representativeness. Data collection involved surveys covering socio-demographic information, the Practice Environment Scale-Nursing Work Index (PES-NWI), and the ProQoL scale. Statistical analyses, including descriptive statistics and Pearson correlation, were performed using SPSS. The participants were predominantly young, with 61.7% less than 30 years old, and 65.4% were male. Most held a bachelor’s degree (54.9%). The survey indicated that the majority reported average levels of compassion satisfaction (90.7%), burnout (91.4%), and secondary traumatic stress (85.2%). The analysis showed that a moderately positive practice environment was significantly associated with lower levels of burnout and higher levels of compassion satisfaction. Additionally, there was a significant difference in mean Compassion Satisfaction scores according to sleep hours (F = 5.475, P < .05). Nurses who slept more than 8 h had significantly higher Compassion Satisfaction compared to those who slept less than 8 h or exactly 8 h (P < .05). ICU nurses generally perceived their work environment positively, though there are opportunities to improve their professional quality of life, particularly by addressing burnout. The findings highlight the need for targeted interventions and further research to enhance job satisfaction and well-being among ICU nurses.

High rates of secondary traumatic stress and burnout have been found across nursing populations. However, few studies have focused on neonatal staff. The objectives of this article are to explore the prevalence and severity of secondary traumatic stress (STS) and burnout in neonatal staff, and identify risk factors and protective factors for STS and burnout within this population with the aim of informing future staff support. A quantitative, cross-sectional study using a survey design was conducted; 246 neonatal staff reported measures of STS, burnout, self-compassion and satisfaction with ward climate. Neonatal staff reported high rates of moderate-severe STS and burnout. STS and burnout were negatively associated with self-compassion and satisfaction with ward climate, suggesting them to be protective factors against STS and burnout. STS was found to be a risk factor for burnout and vice versa. Interventions that increase understanding of STS and burnout, nurture self-compassion, provide support and enhance stress management could help mitigate the impact of STS and burnout amongst neonatal staff.

ABSTRACTBackgroundA skilled and diverse healthcare workforce is essential in nursing homes, yet recruitment and retention remain a major challenge. Gaining insight into the well‐being of different care worker groups and how they perceive their work environment can highlight areas of concern and opportunities for improvement.AimsTo compare the perceived work environment and well‐being among different care worker groups in nursing homes.MethodsThis descriptive study used cross‐sectional survey data from the Flanders Nursing Home (FLANH) project, collected from February–July 2023. A total of 1521 care workers from 25 Flemish nursing homes participated (64.4% response rate), including care assistants (43.7%), registered nurses (20.5%), support staff (15.4%), allied health professionals (14.8%), and team leaders (5.7%). Chi‐squared tests were used to compare the percentages of the care worker groups reporting the work environment items and well‐being outcomes (job satisfaction, intention to leave, burnout). Post hoc analyses were conducted to identify which groups contributed to the significant differences observed.ResultsSignificant differences among care worker groups were found for almost all work environment items and well‐being outcomes. Staffing adequacy was perceived least among care assistants and registered nurses. More registered nurses and team leaders perceived high workload and emotional burden compared to the other groups. Work–life interference and involvement were perceived most among team leaders. A person‐centered vision, work autonomy, and salary satisfaction were reported most among allied health professionals and team leaders. Skill use and training opportunities were reported least among support staff. Work‐related well‐being appeared to be experienced most among allied health professionals and least among care assistants.Linking Evidence to ActionThese findings highlight key differences in work environment perceptions and well‐being among care worker groups, offering valuable insights for tailored initiatives to foster a supportive workplace that benefits the well‐being of all types of care workers in nursing homes.

A comparison of working in small-scale and large-scale nursing homes: A systematic review of quantitative and qualitative evidence

Social class and self-rated health: can the gradient be explained by differences in life style or work environment?

The Ministry of Health, Labour and Welfare (MHLW) states that it is an important issue to realize a work environment where people find their job worth doing, and the MHLW utilizes work engagement as the concept of a job worth doing. In this study, we aimed to clarify the factors related to work engagement in occupational health nurses from both aspects of work environmental and individual factors. An anonymous self-administered questionnaire was mailed to 2,172 occupational health nurses who belonged to the Japan Society for Occupational Health and were in charge of practical work. Among them, 720 responded and their responses were analyzed (valid response rate: 33.1%). The Japanese version of the Utrecht Work Engagement Scale (UWES-J) was used to measure their feelings on whether their job is worth doing. Question items at three levels, namely, work level, department level, and workplace level, were selected from the new brief job stress questionnaire as the work environmental factors. Three scales, namely, professional identity, self-management skills, and out-of-work resources, were used as the individual factors. Multiple linear regression analysis was performed to examine the factors related to work engagement. The mean total score of UWES-J was 57.0 points, and the mean item score was 3.4 points. Among attributes, age, having children, and the position of chief or above were positively correlated to the total score, but the number of occupational health nurses in the workplace was negatively correlated to the total score. Among work environmental factors, work-self balance (positive), which is a subscale at the workplace level, and suitable jobs and opportunities to grow up, which are the subscales at the work level, were positively correlated to the total score. Among individual factors, self-esteem as a professional and self-improvement to be professional, which are the subscales of the professional identity, and problem resolution, which is a subscale of self-management skills, were positively correlated to the total score. In order for occupational health nurses to find their job worth doing, it is desirable that they will have options to choose diverse and flexible work styles, and that their employers will establish a work-life balance for the entire organization. It is preferable that the occupational health nurses can self-improve, and that their employers will provide opportunities for them to develop professionally. The employers should also establish a personnel evaluation system that allows for promotion. Results also suggest that the occupational health nurses need to improve their self-management skills, and that the employers should assign them to positions suitable to their abilities.

The aim of this study was to investigate the transfer of learning of professional competences from vocational colleges to the workplace context in vocational education. Concretely, the study examined the relations between the professional competences learned at school and the use and further development of those competences at the workplace during the practice module in vocational education programmes in Spain. The study analysed individual, educational design and work environment factors that facilitate or hinder transfer of learning. The study took a multidimensional approach to professional competences by observing four dimensions: hard-specific, hard-generic, interpersonal and intrapersonal. The data collection drew from a questionnaire administered to students of vocational education programmes (N = 379) after they had completed the practice module scheme. A moderation analysis was applied to observe the effect of individual, educational design and workplace factors on the relation between the competences learned at school and those used at the workplace. The findings showed that compulsory placement, school-work alignment, work-based supervisor, access to resources and task complexity are significant moderators between the competences learned at school and those used at the workplace. The study highlights the coherence between the school and workplaces and work environment characteristics as factors conducive to transfer of learning.

To examine the relationships among nurse and work characteristics, job satisfaction, stress, burnout and the work environment of haemodialysis nurses. Haemodialysis nursing is characterised by frequent and intense contact with patients in a complex and intense environment. A cross-sectional online survey of 417 haemodialysis nurses that included nurse and work characteristics, the Brisbane Practice Environment Measure, Index of Work Satisfaction, Nursing Stress Scale and the Maslach Burnout Inventory. Haemodialysis nurses reported an acceptable level of job satisfaction and perceived their work environment positively, although high levels of burnout were found. Nurses who were older and had worked in haemodialysis the longest had higher satisfaction levels, experienced less stress and lower levels of burnout than younger nurses. The in-centre type of haemodialysis unit had greater levels of stress and burnout than home training units. Greater satisfaction with the work environment was strongly correlated with job satisfaction, lower job stress and emotional exhaustion. Haemodialysis nurses experienced high levels of burnout even though their work environment was favourable and they had acceptable levels of job satisfaction. Targeted strategies are required to retain and avoid burnout in younger and less experienced nurses in this highly specialised field of nursing.

The relationship of staffing and work environment with implicit rationing of nursing care in Swiss nursing homes – A cross-sectional study

Professional burnout is usually defined as a syndrome of emotional exhaustion, depersonalization and personal derealization, which can manifest itself in many professions, but primarily in helping ones. Persons providing medical care to patients are most at risk of professional burnout. Recent studies have found high rates of burnout and a high prevalence among employees working with patients with novel coronavirus infection during the COVID‑19 pandemic. The purpose of the study is to assess and analyze the levels of components of the burnout syndrome among medical professionals. Material and methods. To assess and analyze the levels of components of professional burnout syndrome, a survey using the «Maslach Burnout» method was conducted among medical workers (MW) of COVID hospitals (n=201); outpatient MW (n=186); MW of multidisciplinary hospitals (n=195), as well as a control group (n=190). Results. A qualitative analysis using the Maslach Burnout Inventory (MBI) method found that 5.5% (11 people) of COVID hospital MRs have an extremely high level of professional burnout. The frequency of occurrence of a high level of burnout is significantly higher in HCWs of COVID hospitals compared to medical workers in multidisciplinary hospitals (pa‑b=0.014). The frequency of occurrence of the average level of burnout is significantly higher in MRs of COVID hospitals compared to medical workers in multidisciplinary hospitals (pa‑b=0.004). It was found that the incidence of low burnout was significantly lower in MRs of COVID hospitals compared to medical workers in multidisciplinary hospitals (pa‑b=0.017). Among medical workers, COVID-hospitals, not a single person with an extremely low level of burnout was recorded. Conclusions. The most susceptible to occupational burnout syndrome were MW of COVID hospitals. 22.4% of MW in COVID hospitals have «high» and «extremely high» levels of burnout, 41.3% have an «average» level and only 36.3% of MW have a low level of burnout. 12.3% of outpatient MW have «high» and «extremely high» levels of burnout, 33.9% have «average» levels and 53.8% of MW have «low» and «extremely low» levels of burnout. 8.2% of MW in multidisciplinary hospitals have a «high» level of burnout, 27.2% have an «average» level and 64.6% of MW have «low» and «extremely low» levels of burnout.

Objectives Dental caries is a health problem that can be prevented. The aim of this study is to analyse if the quality of leadership, in Swedish Public Dental Health clinics, influences the extent to which patients with caries receive preventive care, and if any such effect is mediated through a collaborative work climate, clear role expectations and a low average level of burnout among staff. Methods The multilevel cross-sectional design includes work environment data from surveys of 75 general public dental clinics, register-based data on preventive measures provided to 5398 patients who received a dental filling due to a caries diagnosis, and patient demographics. Using a multilevel path analysis with logistic regression, we tested a model with one direct and three indirect pathways, controlling for the potential confounding effect of patient demographic factors. Results Leadership quality, as assessed by the staff at the clinic, was associated with increased odds of patients with caries receiving prevention, controlling for patient demographic factors. Leadership quality was also positively related to a collaborative work climate, clear role expectations and a low average level of burnout among staff. Against expectations, however, no indirect effect from leadership quality on prevention through the other work environment factors was found. Conclusions In conclusion, the quality of leadership in Swedish Public Dental Health clinics was positively related to a good work environment for staff and to delivery of preventive care to patients experiencing caries.

IntroductionNursing home staff turnover remains a concern in long‐term care facilities, with implications for job performance, organisational morale and patient outcomes. This study explored the factors influencing intention to leave among nursing home care staff in Singapore and focused on the influence of demographic variables, work environment and job satisfaction.MethodsA cross‐sectional survey was employed to collect data from 167 care staff working at two nursing homes in Singapore. Instruments included the Practice Environment Scale of the Nursing Work Index (PES‐NWI), Job Satisfaction Survey (JSS) and Intention to Leave Scale (ILS). Data were analysed using descriptive and inferential statistics, including hierarchical multiple regression, to examine relationships between demographic characteristics, work environment, job satisfaction and intention to leave.ResultsThe study found a moderate overall intention to leave (mean ILS = 9.18, SD = 2.494). Female staff, mid‐career professionals (aged 30–39) and nursing aides exhibited the highest turnover intentions. Job satisfaction, particularly in terms of managerial support and staffing adequacy, emerged as a significant predictor of intention to leave. Work environment factors, especially staffing and resource adequacy, are crucial in turnover intentions.DiscussionThis study highlights key factors driving turnover intentions among nursing home care staff in Singapore. Interventions to mitigate turnover and improve staff retention are recommended to improve staffing levels, managerial support and career development pathways.