title: Nurses' practice environment and work-family conflict in relation to burn out: a multilevel modelling approach.
abstract: OBJECTIVE
  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.
authors.affiliation: Stress Research Institute, Stockholm University, Stockholm, Sweden; Karolinska Institutet, Department of Learning, Informatics, Management and Ethics, Medical Management Center, Stockholm, Sweden.
authors.forename: Constanze
authors.initials: C
authors.lastname: Leineweber
authors.affiliation: Stress Research Institute, Stockholm University, Stockholm, Sweden.
authors.forename: Hugo
authors.initials: H
authors.lastname: Westerlund
authors.affiliation: Stress Research Institute, Stockholm University, Stockholm, Sweden.
authors.forename: Holendro Singh
authors.initials: HS
authors.lastname: Chungkham
authors.affiliation: Karolinska Institutet, Department of Learning, Informatics, Management and Ethics, Medical Management Center, Stockholm, Sweden.
authors.forename: Rikard
authors.initials: R
authors.lastname: Lindqvist
authors.affiliation: Karolinska Institutet, Department of Learning, Informatics, Management and Ethics, Medical Management Center, Stockholm, Sweden.
authors.forename: Sara
authors.initials: S
authors.lastname: Runesdotter
authors.affiliation: Karolinska Institutet, Department of Learning, Informatics, Management and Ethics, Medical Management Center, Stockholm, Sweden.
authors.forename: Carol
authors.initials: C
authors.lastname: Tishelman
mesh_terms: D000328:Adult; D000368:Aged; D002055:Burnout, Professional / Q000209:etiology* / Q000523:psychology*; D003220:Conflict, Psychological; D004644:Emotions; D004777:Environment; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D005222:Mental Fatigue / Q000209:etiology / Q000523:psychology; D008875:Middle Aged; D015233:Models, Statistical; D055361:Multilevel Analysis; D009726:Nurses / Q000523:psychology*; D017132:Workplace / Q000523:psychology*; D055815:Young Adult