Work Engagement Among Advanced Practice Nurses (APNs) in Japan: The Role of Supervisory and Organizational Support

To examine how personal, social support, and organizational factors influence work engagement (WE) among advanced practice nurses (APNs; certified nurses, CNs) in Japan and whether supervisory structure (unified vs. non-unified) moderates these relationships.

APNs (CNs) play a vital role in specialized healthcare, but factors influencing their WE remain underexplored. Previous studies suggest that supervisor support and organizational factors impact nurses' professional motivation and retention.

A cross-sectional web-based survey was conducted among 307 APNs (CNs) from six nursing specialties in Japan. WE was assessed using the Ultra-Short Utrecht Work Engagement Scale (UWES-3). Independent variables included supervisor support (emotional, evaluative, informational, procedural), organizational factors (trust with management, fair evaluation, respect for individuals, career development). Hierarchical multiple regression analyses were performed separately for the unified and non-unified supervisory groups.

Evaluative support positively influenced WE across both groups, emphasizing the importance of structured feedback and professional recognition. Emotional support was negatively associated with WE in the unified group, suggesting that excessive reliance on supervisors may reduce autonomy. Organizational factors did not significantly impact WE, and supervisory structure did not moderate these relationships.

While APNs (CNs) benefit from structured supervisor support, broader organizational policies may be less influential. Prioritizing performance evaluation systems and mentorship programs could enhance APNs' (CNs') engagement and retention.

Healthcare institutions should implement targeted leadership training and structured evaluation systems to sustain APNs' (CNs') motivation and professional development.