Examining Work Engagement in Integrated Nursing-Care Service Wards: Insights from Structural Equation Modeling

Background. In 2016, the South Korean Integrated Nursing-Care Service, covered by national insurance, was initiated, with a particular focus on cancer-oriented units. Integrated Nursing-Care Service Wards denote facilities wherein nursing professionals deliver holistic care, in the absence of paid informal caregivers (hereafter will be called caregiver). Aim. This study, framed within Demerouti’s Job Demands-Job Resources Model, aimed to analyze variables influencing nurses’ work engagement in Integrated Nursing-Care Service wards. Methods. From April to June 2022, 375 participants working at three certified tertiary hospitals operating Integrated Nursing-Care Service wards completed the survey. Of the 400 distributed questionnaires, 375 were used for analysis, resulting in a response rate of 93.75%. The remaining 25 questionnaires were excluded due to insufficient responses. Job demands, job resources, and personal resources were assigned as exogenous variables that predicted burnout and work engagement of nurses, while burnout and work engagement were assigned as endogenous variables. In this model, 32 hypotheses were established, and to verify the hypotheses, the direct effect of each exogenous variable on work engagement and the indirect effect through burnout as a medium were analyzed. Results. Burnout partially mediated the impact of exogenous variables on work engagement. The subfactors revealed partial mediation between emotional labor and work engagement, full mediation for satisfaction with the recognition from patients and caregivers, and partial mediation for resilience. Conclusion. Emotional labor had the highest impact on nurses’ burnout in Integrated Nursing-Care Service wards, followed by resilience and satisfaction with the recognition from patients and caregivers. Nurses’ burnout, work environment, emotional labor, work overload, and resilience significantly influenced their work engagement. Implications for Nursing Management. The results of this study are useful as basic data for research on intervention programs that reduce burnout and increase nurses’ work engagement in Integrated Nursing-Care Service wards.