Temporal Changes in Nurse Mental and Behavioral Health Modified by Job Demands and Resources

The COVID-19 pandemic exacerbated barriers in the nurse work environment, influencing nurse well-being. This paper examines if workplace factors moderate temporal changes in the mental and behavioral health of nurses.

Cross-sectional data from the HealthyNurse survey collected between May 2017 and July 2023 were analyzed (n = 34,273). Job resources was estimated by average agreement (0 = strongly disagree to 4 = strongly agree) with being treated with respect, recognized for efforts, and the employer values their well-being. Average agreement with working overtime, being assigned a high workload, and working through breaks estimated job demands. Multivariable regression models estimated the effect modification of job demands and job resources on changes over time in hours of sleep and odds of feeling sad, down, or depressed, past 30-day binge drinking, and current tobacco use.

By each year, nurses increased sleep hours (b = 0.011; 95% CI [0.004, 0.018]), but had greater odds of poor mental health (OR = 1.102; 95% CI [1.086, 1.117]), binge drinking (OR = 1.022, 95% CI [1.007, 1.036]), and tobacco use (OR = 1.070; 95% CI [1.043, 1.098]). With higher job resources, sleep increased at a greater rate over time (b = 0.016; 95% CI [0.007, 0.024]) and the odds of binge drinking increased at a lower rate over time (OR = 0.981; 95% CI [0.965-0.998]). Conversely, the prevalence of poor mental health increased at a greater rate over time when job demands were high (OR = 1.018; 95% CI [1.004, 1.033]).

Job demands and job resources may lead to differential mental and behavioral health among nurses. Understanding how these workplace factors can influence nurse health is an important and upstream approach to support well-being in times of crisis.