Comparing Job Stress and Well-Being Between Hospital and Long-Term Care Nurses: A Cross-Sectional Study in Taiwan

As population aging intensifies, the nursing workforce faces increasing pressure across hospital and long-term care (LTC) sectors. Understanding how different work environments influence job stress and well-being is essential for improving workforce sustainability and care quality.

This study aimed to compare job stress and well-being between hospital and LTC nurses in Taiwan and to identify key demographic, occupational, and psychosocial factors associated with well-being.

Design and methods were guided by the Job Demands-Resources (JD-R) framework. A cross-sectional design was conducted with 275 registered nurses recruited from hospitals and LTC institutions. Data were collected using a structured questionnaire that included the Nursing Staff Stress Scale and the WHO-5 Well-Being Index. Descriptive statistics, independent t-tests, Pearson correlations, and multiple regression analyses were performed.

Hospital nurses reported significantly higher job stress, particularly in the domains of personal response, work concern, and inability to complete private work, while LTC nurses demonstrated higher levels of well-being. Well-being was negatively correlated with job stress. Regression analysis revealed that shorter working hours, fewer delayed off-duty occurrences, higher income, being married, and higher education were significantly associated with better well-being. The final model explained 37% of the variance in well-being.

Substantial differences in stress and well-being exist between hospital and LTC nurses. Addressing workload, improving organizational support, and promoting balanced work conditions are essential for sustaining the mental health and stability of the nursing workforce. These findings provide actionable insights for nursing managers and policymakers aiming to design evidence-based interventions that enhance workforce sustainability and psychological health. Practical strategies-such as reducing excessive working hours, minimizing delayed off-duty time, and strengthening leadership support and flexible scheduling systems-are essential to enhance nurses' well-being and workforce sustainability.