Multi-level analysis of individual and work environment factors associated with nurses' perceived emotional exhaustion

Background: Several factors at the individual- and work environment-level were suggested to correlate with emotional exhaustion development in nurses. Aim: To explore nurses' perceived emotional exhaustion and associated factors by employing hierarchical modelling techniques. Methods: 1539 nurses completed the cross-sectional survey. Generalized Linear Mixed Model was performed to identify predictors of emotional exhaustion. Results: At the individual level, female gender, high workload and emotional job demands increased the risk of emotional exhaustion; instead, higher education, satisfaction with the role of follower, perceiving nursing profession as meaningful, feeling independent at work, and group closeness were protective factors. At the work environment level, hospital ward type did not affect emotional exhaustion. Conclusions: Emotional exhaustion is largely influenced by ward culture and organizational policies, and to a lower extent by socio-demographic variables. Moreover, it emerges as an intrinsic risk of the nursing profession rather than being associated with the clinical area profile.