title: Relationships of work and practice environment to professional burnout: testing a causal model.
abstract: BACKGROUND
  Research has established clear links between nurses' experience of professional burnout and many qualities of work environments but more work is needed to clarify interrelationships among aspects of complex organizational settings.
  
  
  OBJECTIVE
  To test a nursing worklife model that defined structured relationships among professional practice environment qualities and burnout.
  
  
  METHODS
  Hospital-based nurses in Canada (N = 8,597) completed an assessment of worklife (Nursing Work Index, NWI) and burnout (Maslach Burnout Inventory-Human Service Scale, MBI-HSS).
  
  
  RESULTS
  A causal model was used to confirm the factor structure of the Professional Environment Scale (NWI-PES) on a subset of NWI items and the factor structure of the MBI-HSS. The analysis provided support for a structural model (nursing worklife model) linking the five worklife factors used to define a fundamental role for nursing leadership in determining the quality of worklife regarding policy involvement, staffing levels, support for a nursing model of care, and physician-nurse relationships. The analysis supported a direct path (negatively weighted) from staffing to emotional exhaustion and a direct path (positively weighted) from nursing model of care to personal accomplishment.
  
  
  CONCLUSIONS
  Implications for refining a model of worklife are discussed. Implications for enhancing the quality of worklife and supporting engagement with work are considered.
authors.affiliation: Occupational Health and Wellness, Centre for Organizational Research and Development, Acadia University, Wolfville, Nova Scotia, Canada. michael.leiter@acadiau.ca
authors.forename: Michael P
authors.initials: MP
authors.lastname: Leiter
authors.forename: Heather K
authors.initials: HK
authors.lastname: Spence Laschinger
mesh_terms: D000328:Adult; D000416:Alberta; D002055:Burnout, Professional / Q000517:prevention & control* / Q000523:psychology; D015984:Causality; D005163:Factor Analysis, Statistical; D005260:Female; D006272:Health Facility Environment; D006801:Humans; D008297:Male; D016294:Models, Nursing; D009741:Nursing Staff, Hospital / Q000458:organization & administration / Q000523:psychology*; D009864:Ontario; D010559:Personnel Management; D015203:Reproducibility of Results