Key drivers of nurse burnout and work engagement in Europe: A cross-sectional dominance analysis

Background: Following the Job Demands-Resources model, job resources are key drivers of work engagement, while excessive job demands and insufficient job resources are linked to job strain and burnout. Yet, little is known about the relative importance of different job demands and resources in comparison to one another. Objective: Using dominance analysis, this study aimed to investigate the relative importance of specific job demands and job resources for burnout and work engagement among direct care nurses in Europe. Design: A cross-sectional survey study. Setting: 64 general acute care hospitals in Belgium (13), Germany (20), Ireland (15), Norway (1), Sweden (4), and England (11). Participants: Direct care nurses (n = 5023). Methods: Data were collected between May 2022 and August 2022. To evaluate the measurement model, structural equation modeling was performed in the pooled sample and within each country. Due to model misfit (Tucker Lewis Index < 0.89), Norway and Sweden were excluded from further analysis, resulting in a final sample of 4591 nurses. Multiple-group confirmatory factor analysis was used to test configural and metric measurement invariance across countries. In the next step, the main propositions of the Job Demands-Resources model were tested, followed by dominance analysis to determine the relative importance of specific job demands and job resources on overall work engagement and burnout. Results: In line with the Job Demands-Resources model, job demands contributed to burnout (β = 0.681, p < 0.001), while job resources were positively linked to work engagement (β = 0.614, p < 0.001) and negatively associated with burnout (β = − 0.258, p < 0.001). These relationships were consistent across countries. Dominance analyses further revealed that skill utilization was the strongest predictor of work engagement, explaining between 27.4 % and 41.9 % of the variance, while emotional dissonance (%R² = 17.0 %–23.8 %) and emotional demands (%R² = 17.3 %–20.8 %) were the strongest predictors of burnout. Overall, these findings were consistent across countries. Conclusions: This study adds to existing research on Job Demands-Resources theory by uncovering the relative importance of specific job demands and resources for burnout and work engagement among European nurses. The findings can guide hospitals in prioritizing policies and practices to enhance nurses' well-being. Trial registration: The study described herein is funded under the European Union's Horizon 2020 Research and Innovation programme from 2020 to 2024 (Grant Agreement 848031). The protocol of Magnet4Europe is registered in the ISRCTN registry (ISRCTN10196901).