Psychosocial hospital work environment and nurses' health assessed with salutogenic indicators: a systematic review

This study aimed to systematically review scientific evidence on how the psychosocial work environment affects nurses' health and well-being through salutogenic health indicators.

The literature search was conducted from February to April, 2025, using the keywords psychosocial work environment, nurses' health, salutogenic health indicators, SHIS, WEMS, nurses' well-being in PubMed and Google Scholar. The search strategy followed PRISMA 2020 guidelines. After applying the exclusion criteria (publication period earlier than 2015 or later than 2024, and publication language other than English or Lithuanian), duplicate removal, abstract screening and quality assessment of the studies, 14 studies published from 2015 to 2024 were included in the final review. The quality of the included studies was assessed using the Joanna Briggs Institute Critical Appraisal Tools, the Mixed Methods Appraisal Tool and the Critical Appraisal Skills Programme. Studies were included if they reached at least 60% of the maximum possible score according to the relevant checklist, corresponding to "moderate to high quality". Studies that scored below this threshold or did not provide sufficient methodological information were excluded from the final analysis.

Positive psychosocial factors such as social support, autonomy, role clarity, and participatory leadership were consistently linked to improved well-being. For instance, nurses with higher sense of coherence scores reported significantly lower burnout and depression risk, while higher job control and collaboration were associated with better job satisfaction and engagement. Salutogenic Health Indicator Scale scores indicated that up to 60% of nurses experienced frequent physical and emotional symptoms related to workplace stressors, and Work Experience Measurement Scale results highlighted that favorable work environments were strongly associated with higher well-being (p < 0.05). In contrast, negative factors, particularly excessive workload, time pressure, lack of managerial support, and workplace conflict were strongly correlated with increased stress symptoms, emotional exhaustion, and reduced motivation across multiple settings.

The psychosocial work environment plays a crucial role in shaping nurses' health and well-being. Strengthening salutogenic resources and addressing adverse psychosocial factors could enhance nurses' resilience and contribute to sustainable workforce retention.