Nurses' practice environment and work-family conflict in relation to burn out: a multilevel modelling approach

PLoS One. 2014 May 12;9(5):e96991. doi: 10.1371/journal.pone.0096991. eCollection 2014.


Objectives: To investigate associations between nurse work practice environment measured at department level and individual level work-family conflict on burnout, measured as emotional exhaustion, depersonalization and personal accomplishment among Swedish RNs.

Methods: A multilevel model was fit with the individual RN at the 1st, and the hospital department at the 2nd level using cross-sectional RN survey data from the Swedish part of RN4CAST, an EU 7th framework project. The data analysed here is based on a national sample of 8,620 RNs from 369 departments in 53 hospitals.

Results: Generally, RNs reported high values of personal accomplishment and lower values of emotional exhaustion and depersonalization. High work-family conflict increased the risk for emotional exhaustion, but for neither depersonalization nor personal accomplishment. On department level adequate staffing and good leadership and support for nurses reduced the risk for emotional exhaustion and depersonalization. Personal accomplishment was statistically significantly related to staff adequacy.

Conclusions: The findings suggest that adequate staffing, good leadership, and support for nurses are crucial for RNs' mental health. Our findings also highlight the importance of hospital managers developing policies and practices to facilitate the successful combination of work with private life for employees.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Burnout, Professional / etiology*
  • Burnout, Professional / psychology*
  • Conflict, Psychological*
  • Emotions
  • Environment
  • Family*
  • Female
  • Humans
  • Male
  • Mental Fatigue / etiology
  • Mental Fatigue / psychology
  • Middle Aged
  • Models, Statistical
  • Multilevel Analysis*
  • Nurses / psychology*
  • Workplace / psychology*
  • Young Adult

Grant support

CL, RL and HSC are financed by two research projects and a centre of excellence grant from the Swedish Council for Working Life and Social Research (FAS # 2011-0403, #2009-1077 550 and #2009-1758). The authors have received funding from the European Union's Seventh Framework Program (FP7/2007-2013) under grant agreement no. 223468 and the Swedish Association of Health Professionals, the regional agreement on medical training and clinical research (ALF) between Stockholm County Council and Karolinska Institutet, Committee for Health and Caring Sciences (CfV) and Strategic Research Program in Care Sciences (SFO-V) at Karolinska Institutet. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.