Balancing demands and rewards: a cross-sectional examination of well-being and professional identity among nurses

平衡需求与回报:一项关于护士幸福感和职业认同的横断面研究

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Abstract

BACKGROUND: Increasing healthcare demands and a growing nursing shortage contribute to high workloads, psychosocial strain, and risks to care quality. Organisational conditions, job demands, and resources strongly influence nurses' well-being, retention, and performance. AIM: To examine how nurses balance organisational demands and opportunities, and how these factors relate to work environment, well-being, and professional identity. METHOD: A cross-sectional survey was completed by 2704 nurses in Sweden. Participants were grouped by age based on the median (⩽51 vs ⩾52 years) and by gender. Descriptive statistics and chi-square tests were conducted, with missing data handled using pairwise deletion. Findings were interpreted through the job demands-resources and effort-reward imbalance frameworks. RESULTS: Younger nurses experienced higher physical workloads, lower recognition, lower joy and satisfaction, whereas older nurses reported better health, higher psychological work ability, and greater professional pride. Female nurses reported stronger self-imposed pressure and social community, whereas male nurses indicated higher work ability and better sleep. Across all groups, nurses demonstrated strong professional identity, but workload and recovery burdens were evident. CONCLUSION: Strengthening key resources - autonomy, recognition, and social support - while addressing systemic workload pressures may enhance sustainability, particularly for early-career nurses and support long-term health, professional identity, and workforce retention.

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