Factors associated with work-life balance among emergency physicians, nurses, and paramedics: a systematic review

This systematic review aimed to identify and synthetically evaluate factors asso ciated with work-life balance (WLB) among emergency physicians, emergency nurses, and paramedics.

The review was conducted in accordance with the PRISMA 2020 guidelines and was prospectively registered in the PROSPERO database. A comprehensive search of PubMed, Scopus, Web of Science, and CINAHL was performed, encompassing English-language publications from 2015 to 2025. Inclusion criteria were defined using the PICOS framework. Methodological quality was appraised using Joanna Briggs Institute (JBI) critical appraisal tools. Furthermore, the overall certainty and confidence in the evidence were assessed using the GRADE (for quantitative data) and GRADE-CERQual (for qualitative data) frameworks.

From 202 identified records, 11 studies met the inclusion criteria: 10 quantitative cross-sectional studies and one qualitative study. The findings indicate that the primary determinants of WLB impairment among emergency personnel include high occupational stress, Effort-Reward Imbalance (ERI), Work-Family Conflict (WFC), shift-work patterns, and adverse organizational characteristics, such as staffing shortages and limited team support. Numerous studies demonstrated robust associations between WLB disturbances and professional burnout, deterioration of somatic and mental health, sleep disorders, and diminished job satisfaction. According to GRADE criteria, the certainty of quantitative evidence was predominantly rated as low or very low; however, the qualitative study provided evidence of moderate-to-high confidence (GRADE-CERQual).

The findings underscore the critical necessity of implementing multilevel organizational interventions aimed at enhancing working conditions, mitigating work-family conflict (WFC), and bolstering team-based support. Such strategies are pivotal for safeguarding the occupational well-being of the emergency medicine workforce. Addressing these structural determinants is essential to ensure long-term staff retention and the sustainability of emergency care systems.

https://www.crd.york.ac.uk/PROSPERO/view/CRD420251237774, identifier: CRD420251237774.