The relationship between practice environment and work engagement in intensive care nurses: The mediating role of...

Intensive care nurses face challenging work environments and experience more moral challenges, which can affect their work engagement. Moral resilience may reduce the risk of such adverse outcomes. While the importance of enhancing nurses' mental health for care quality is well established, research on the relationship between perceived practice environment, moral resilience, and work engagement is still lacking.

The aim of this study was to assess the practice environment, moral resilience, and work engagement among Chinese intensive care nurses and to examine whether moral resilience mediates the association between the practice environment and work engagement.

A convenience sampling method was used to select intensive care nurses from six tertiary first-class general hospitals in Henan province as participants from December 2024 to January 2025. The General Demographic Questionnaire, Practice Environment Scale of the Nursing Work Index, Rushton Moral Resilience Scale, and Utrecht Work Engagement Scale (UWES-9) were used as survey tools. The mediating effect model was constructed using Amos 23.0 software.

A total of 284 intensive care nurses were surveyed. The moral resilience score was 46.38 ± 7.26, the practice environment score was 96.40 ± 18.42, and the work engagement score was 34.94 ± 10.80. All three variables showed positive correlations. Moral resilience partially mediated the relationship between perceived practice environment and work engagement, with a mediating effect size of 0.053, accounting for 5.59% of the total effect.

This study highlights that the perceived practice environment for intensive care nurses can enhance their self-reported work engagement and that moral resilience can further boost this engagement. Nursing administrators should focus on building support systems and optimising the environment. This involves enhancing the intensive care unit's practice environment and providing moral resilience training to help nurses maintain their mental health.