A study of the determinants of work-to-family conflict among hospital nurses in Belgium

Overtime work and Chinese workers' physical and mental health: The mediating role of social support and work value awareness

BACKGROUND

China was once called the world's factory. Chinese workers had long weekly working hours. However, the empirical results of the relationship between overtime work and workers' health are mixed and remain inconclusive.

OBJECTIVE

This study aimed to investigate how overtime work influenced workers' physical and mental health and the role of lifestyles, social support, and work value awareness.

METHODS

Data from the China Labor-force Dynamics Survey 2016 (N = 14,205) was used. The instrumental variable approach was employed to overcome the endogeneity problem between overtime work and workers' health. The bootstrapping method was conducted to elicit the role of lifestyles, social support, and work value awareness.

RESULTS

The results indicated that overtime work significantly and negatively influenced Chinese workers' physical and mental health. The results of the bootstrapping suggested that workers' social support and work value awareness partially mediated the relationship between overtime work and their physical and mental health. However, the mediating role of lifestyles was insignificant.

CONCLUSION

Through using big data with national representativeness, this study suggests that overtime work negatively influences Chinese workers' physical and mental health. Our findings provide policy implications for improving workers' health rights and well-being in emerging economies.

The nurse manager support process in the work-family conflict of clinical nurses: a qualitative study

Background

Nurses are exposed to work-family conflict because of the high expectations associated with the workplace and family demands. Nurse managers' support for work-family conflict requires theoretical principles.

Aims

The current study explores managers' experiences of work-life conflict and how they manage this.

Methods

Grounded theory is used to explain the theoretical principles of nursing managers' support to clinical nurses. Participants included 20 managers and 2 clinical nurses working in one hospital. The data collection method used unstructured interviews. Sampling was first purposive and then theoretical, and data analysis was carried out using Corbin and Strauss's approach.

Results

Participants' primary concern was the threat to their organisational position, and they used a functional-exchangeable conservation strategy to consolidate their own positions. The strategy resulted in the consolidation of managers' and nurses' positions. Two factors were identified as influencing nurse managers' strategies, namely 'the sense of insecurity in the functional position' with a deterrent effect, and 'cooperative atmosphere' as a facilitator with a positive effect.

Conclusion

The most important supportive strategy used by nurse managers in the work-family conflict of clinical nurses was based on 'functional-exchangeable conservation' between themselves and the nursing staff. Functional- exchangeable protection is a type of protection of human resources by the manager. In this exchange, to solve the conflict between work and family for the nurse, the nursing manager wants to maintain their managerial position by solving the nurse's problem. Both of them benefit from this exchange. The theory of functional-exchangeable protection may provide the necessary background for the development of a prescriptive theory to minimise nurses' worries about family matters. Flexible work schedules may help nurses resolve work-family conflict and so provide better care and reduce work errors. The concept of functional-exchangeable protection and its subclasses may be helpful in preparing policies to support clinical nurses through implementing flexible work schedules, increasing nurses' motivation and fulfilling the family role of nurses.

Investigating Factors Influencing Medical Practitioners' Resistance to and Adoption of Internet Hospitals in China: Mixed Methods Study

BACKGROUND

The swift shift toward internet hospitals has relied on the willingness of medical practitioners to embrace new systems and workflows. Low engagement or acceptance by medical practitioners leads to difficulties in patient access. However, few investigations have focused on barriers and facilitators of adoption of internet hospitals from the perspective of medical practitioners.

OBJECTIVE

This study aims to identify both enabling and inhibiting predictors associated with resistance and behavioral intentions of medical practitioners to use internet hospitals by combining the conservation of resources theory with the Unified Theory of Acceptance and Use of Technology and technostress framework.

METHODS

A mixed methods research design was conducted to qualitatively identify the factors that enable and inhibit resistance and behavioral intention to use internet hospitals, followed by a quantitative survey-based study that empirically tested the effects of the identified factors. The qualitative phase involved conducting in-depth interviews with 16 experts in China from June to August 2022. Thematic analysis was performed using the qualitative data analysis software NVivo version 10 (QSR International). On the basis of the findings and conceptual framework gained from the qualitative interviews, a cross-sectional, anonymous, web-based survey of 593 medical practitioners in 28 provincial administrative regions of China was conducted. The data collected were analyzed using the partial least squares method, with the assistance of SPSS 27.0 (IBM Corp) and Mplus 7.0 (Muthen and Muthen), to measure and validate the proposed model.

RESULTS

On the basis of qualitative results, this study identified 4 facilitators and inhibitors, namely performance expectancy, social influence, work overload, and role ambiguity. Of the 593 medical practitioners surveyed in the quantitative research, most were female (n=364, 61.4%), had a middle title (n=211, 35.6%) or primary title (n=212, 35.8%), and had an average use experience of 6 months every year. By conducting structural equation modeling, we found that performance expectancy (β=-.55; P<.001) and work overload (β=.16; P=.005) had the most significant impact on resistance to change. Resistance to change fully mediated the influence of performance expectancy and partially mediated the influences of social influence (variance accounted for [VAF]=43.3%; P=.002), work overload (VAF=37.2%; P=.03), and role ambiguity (VAF=12.2%; P<.001) on behavioral intentions to use internet hospitals. In addition, this study found that the sex, age, professional title, and use experience of medical practitioners significantly moderated the aforementioned influencing mechanisms.

CONCLUSIONS

This study investigated the factors that facilitate or hinder medical practitioners' resistance to change and their behavioral intentions to use internet hospitals. The findings suggest that policy makers avoid the resistance and further promote the adoption of internet hospitals by ensuring performance expectancy and social influence and eliminating work overload and role ambiguity.

Work-family conflict and the professional quality of life and their sociodemographic characteristics among nurses: a cross-sectional study in Tehran, Iran

Background

Nurses are exposed to work-family conflict (WFC) due to specific occupational conditions, such as exposure to patients and shift work, which can affect the professional quality of life (ProQoL). The aim of the present study was to determine the relationship between different levels of work-family conflicts and professional quality of life and their sociodemographic characteristics among the nurses in two hospitals in Tehran, Iran.

Methods

This cross-sectional study included 234 nurses from two hospitals. Data were collected using a three-part questionnaire, including items related to nurses’ demographic characteristics, the WFC questionnaire, and the ProQoL questionnaire.

Results

There was a significant positive correlation between conflict in terms of time and behavior with compassion satisfaction and between the three types of conflict with job burnout (p < 0.05). The results indicate that the WFC and ProQoL scores and the mean WFC were higher among women, people who had a disabled family member, and nurses who worked equal to or more than 175 hours a month. Regarding the dimensions of ProQoL, the mean compassion satisfaction was lower among people who lived with their parents, people who had a second job had a child younger than one-year-old, and a disabled family member had higher means of job burnout. Also, those who had younger children experienced less PTSD. Furthermore, the mean of WFC and burnout among single nurses was significantly lower than among married and divorced/widowed nurses. Additionally, the mean of WFC and burnout among nurses living in rental houses and nurses reporting the level of satisfying relationships with co-workers as ‘bad’ were significantly more than for other nurses.

Conclusion

Stable mental and emotional conditions are of great importance for nurses to provide safe and quality services to their patients. The results also revealed that nurses’ compassion satisfaction and job burnout were associated with different types of conflict. The WFC of nurses is related to their ProQoL and affects their job satisfaction and burnout. Reducing conflict may improve the nurses’ satisfaction and thus improve patient care and healthcare services.

The life history narrative of clinical nurses with more than 30 years of experience

BACKGROUND

The nurses with long-term careers in clinical settings shows a clear declining trend. Recording the specific period in Korea's nursing history is also important from a historical perspective. The aim of this study was to analyze the life history narrative of clinical nurses who have been in service for more than 30 years and to explore the strength and structure of their experience that enabled them to retain their long-term careers.

METHODS

This study conducted qualitative research with a life history narrative. For data collection, biographical-narrative interview through in-depth personal interviews with six participants. The participants were clinical nurses who had worked at a general hospital for more than 30 years. The interviews were conducted in three sessions per participant, each session lasting 90-180 min. Qualitative thematic analysis was used to analyze the data.

RESULTS

The narrative of their life stories were analyzed by dividing them into "Dimensions," "Turnings" and "Adaptations". The dimensions were categorized into individual and career dimensions. Turning points were empirical and environmental conditions that posed a threat to their career retention as nurse clinicians. Adaptations were illustrated individual methods and social interactions. Twenty-four themes were derived from the 94 thematic statements. After the abstract, four comprehensive categories emerged. The core theme for retaining long-term careers, with "Finding value in myself" comprising four themes: "acknowledgement and support from families," "healthy relationship at work," "trusting myself'," and "accumulation of small achievements."

CONCLUSIONS

The life narratives of participants reveal a close connection with and relationship between the changes in the social aspects, the fields of healthcare and nursing, their individual predispositions, family recognition, and organizational support at that time in Korea. The healthy interpersonal relationships in work place are the most important condition in maintaining the long-term work of nurses. The experience of nurses in one era may not be able to represent experiences in another era, so an in-depth study exploring the social context seems to be necessary. There is a need for policies and changes in the field that can keep the lives of professional women working as nurses proudly.

Towards Better Understanding of the Harmful Impact of Hindrance and Challenge Stressors on Job Burnout of Nurses. A One-Year Cross-Lagged Study on Mediation Role of Work-Family Conflict

The mediation role of work–family conflict (WFC) in job demands – job burnout link is well documented, also in group of nurses. It is still unclear, however, which job demands are particularly conducive to WFC and job burnout. Moreover the mediational effect of WFC was tested mainly in cross-sectional studies that were conducted in countries of North America and Western Europe. Drawing on the Job Demands-Resources and the Effort-Recovery models, this one-year cross-lagged study investigates the effects of five types of job demands related to challenge and hindrance stressors on job burnout (measured with exhaustion and disengagement from work) as well as the mediational role of WFC in Polish nurses. Job demands included emotional, cognitive demands, and demands for hiding emotions (as challenge stressors) as well as quantitative demands and work pace (as hindrance stressors). Data were collected among 516 nurses. Structural equation modelling (SEM) showed that hindrance stressors (T1) are predictor of higher job burnout (T2). The positive role of challenge stressors (T1) were not supported. Only emotional demands were associated with exhaustion but the direction of the relation was opposite than expected. WFC (T1) mediated the harmful effect of the two hindrance stressors and emotional demands on disengagement from work (but not on exhaustion). Cognitive demands and demands for hiding emotions were not related to negative outcomes. The obtained results shed light on the role of the challenge-hindrance stressors and WFI in development of job burnout. The implications for theory and research on the mental health of nurses are discussed.

Workaholism, presenteeism, work-family conflicts and personal and work outcomes: Testing a moderated mediation model

AIMS AND OBJECTIVES

While research suggests that nurses who experience work-family conflicts (WFC) are less satisfied and perform less well, these negative outcomes may be more important for some nurses. This study proposes a mediated moderation model wherein the interaction between two individual characteristics, workaholism and presenteeism, relates to family life satisfaction and work performance with WFC mediating these relationships.

BACKGROUND

Because a limited number of nursing studies have examined the potential outcomes of workaholism and presenteeism, we extend past research to address the question of how workaholism and presenteeism affect nurses' functioning.

DESIGN

We used a cross-sectional questionnaire survey design to test our hypotheses. STROBE guidelines for cross-sectional research were followed in designing and reporting this study.

METHODS

A total of 419 nurses completed measures of workaholism, presenteeism, WFC, family life satisfaction and work performance.

RESULTS

Results revealed that the relationships between workaholism and outcomes (family life satisfaction and work performance) through WFC were stronger among nurses characterised by high levels of presenteeism.

CONCLUSIONS

These results revealed that high presenteeism may exacerbate the negative relationships of workaholism to family life satisfaction and work performance through WFC.

RELEVANCE TO CLINICAL PRACTICE

Healthcare organisations and managers should consider addressing work environment factors in their efforts to reduce the negative outcomes (e.g., low family satisfaction and work performance) of nurses' workaholism, presenteeism and WFC.

A comparative analysis of work-family conflict among staff, managerial, and executive nurses

BACKGROUND

Nurses frequently are caught between the demands of work and family. While studies have explored this issue among staff nurses, none have compared nurse leaders to staff nurses. This study compares work-family conflict (WFC) and family-work conflict (FWC) among staff, managerial, and executive nurses.

METHODS

In this survey design, 20% of registered nurses were randomly sampled across Florida with a 9% response rate. Survey questions included personal, professional, and work environment characteristics and perceptions of WFC/FWC. Analyses of variance tested the differences between- and within-group scores for WFC/FWC for staff, managerial, and executive nurses. Ordinary Least Squares regressions tested the relationships between personal, professional and work environment measures, focusing on the three different nursing roles, and WFC/FWC scores.

FINDINGS

Nurses experienced more WFC than FWC. Staff nurses experienced significantly less WFC than nurse managers and nurse executives (analysis of variance mean difference -0.881 and -2.693, respectively). Nonwhite nurses experienced more WFC and FWC than white nurses. Longer shift length predicted greater WFC. FWC was lower with paid leave for childbirth.

DISCUSSION

Higher WFC among nurse managers and executives may discourage nurses from taking on or staying in leadership roles. Efforts must be taken to decrease WFC/FWC among nurses in these roles.

Juggling family and professional caring: Role demands, work-family conflict and burnout among registered nurses in Ghana

AIM

Juggling work and family responsibilities remains an important concern for both employees and organizations. This study aimed at examining work and family demands as predictors of work-family conflict and the relationship between work-family conflict and burnout among registered nurses in Ghana.

DESIGN

The study adopted a cross-sectional survey design.

METHODS

Data were collected from a sample of 134 registered nurses selected from five public hospitals in Accra through convenience sampling. Participants responded to structured questionnaires that assessed, among others, experiences of work-family conflict and burnout.

RESULTS

Multiple regression analyses showed that long work hours and weekend schedules were associated with higher levels of work-to-family conflict, while the number of older dependants at home was positively related to family-to-work conflict. Family-to-work conflict was positively related to burnout, while work-to-family conflict was not significantly related to burnout.

"We Won't Retire Without Skeletons in the Closet": Healthcare-Related Regrets Among Physicians and Nurses in German-Speaking Swiss Hospitals

Physicians and nurses are expected to systematically provide high-quality healthcare in a context marked by complexity, time pressure, heavy workload, and the influence of nonclinical factors on clinical decisions. Therefore, healthcare professionals must eventually deal with unfortunate events to which regret is a typical emotional reaction. Using semistructured interviews, 11 physicians and 13 nurses working in two different hospitals in the German-speaking part of Switzerland reported a total of 48 healthcare-related regret experiences. Intense feelings of healthcare-related regrets had far-reaching repercussions on participants' health, work-life balance, and medical practice. Besides active compensation strategies, social capital was the most important coping resource. Receiving superiors' support was crucial for reaffirming professional identity and helped prevent healthcare professionals from quitting their job. Findings suggest that training targeting emotional coping could be beneficial for quality of life and may ultimately lead to lower job turnover among healthcare professionals.

Perceived organizational support and employee well-being

Purpose

Considering work and family responsibility has become an important issue due to changes in the lives of people, understanding work and family responsibilities is essential for organizations in assisting employees to increase their well-being. Therefore, the purpose of this paper is to find the impact of perceived organizational support (POS) on work–family facilitation (WFF) and work–family conflict (WFC) and eventually on employee well-being.

Design/methodology/approach

A survey questionnaire is administered to 1,340 employees of Chinese enterprises. Structural equation modeling is used to test the model fit.

Findings

Results of this study indicate a significant positive relationship between POS and WFF and significant negative relation between POS and WFC. Results of this paper also indicate that WFF and WFC partially mediate the relationship between POS and employee well-being.

Originality/value

Over the past two decades, the extent of research on work–family literature has been increased. Most of the work–family research works have been conducted in the Western countries. Very little is known about whether these results are applicable to Eastern societies. This study is extended to focus on work–family literature by drawing a sample from different regions of China. The findings of this study may provide a good understanding of WFC and WFF for Chinese employees. This study stresses the importance of providing organizational support to increase the well-being of employees.

Are changes in objective working hour characteristics associated with changes in work-life conflict among hospital employees working shifts? A 7-year follow-up

OBJECTIVE

To investigate whether changes in objective working hour characteristics are associated with parallel changes in work-life conflict (WLC) among hospital employees.

METHODS

Survey responses from three waves of the Finnish Public Sector study (2008, 2012 and 2015) were combined with payroll data from 91 days preceding the surveys (n=2 482, 93% women). Time-dependent fixed effects regression models adjusted for marital status, number of children and stressfulness of the life situation were used to investigate whether changes in working hour characteristics were associated with parallel change in WLC. The working hour characteristics were dichotomised with cut-points in less than or greater than 10% or less than or greater than25% occurrence) and WLC to frequent versus seldom/none.

RESULTS

Change in proportion of evening and night shifts and weekend work was significantly associated with parallel change in WLC (adjusted OR 2.19, 95% CI 1.62 to 2.96; OR 1.71, 95% CI 1.21 to 2.44; OR 1.63, 95% CI 1.194 to 2.22, respectively). Similarly, increase or decrease in proportion of quick returns (adjusted OR 1.45, 95% CI 1.10 to 1.89) and long work weeks (adjusted OR 1.26, 95% CI 1.04 to 1.52) was associated with parallel increase or decrease in WLC. Single days off and very long work weeks showed no association with WLC.

CONCLUSIONS

Changes in unsocial working hour characteristics, especially in connection with evening shifts, are consistently associated with parallel changes in WLC.

Staff working in hospital units with greater social capital experience less work-home conflict: Secondary analysis of a cross-sectional study

BACKGROUND

When the interplay between work and private life does not function correctly (work-home conflict), this constitutes a well-known risk factor for poorer health, increased absenteeism and lower work performance. Information about influencing factors of work-home conflict is therefore indispensable in order to avoid it. In this study, we analyse whether a good working atmosphere that fosters mutual trust, support and a 'sense of unity' (organizational social capital) can reduce an employee's conflict between work and private life.

OBJECTIVE

This study investigates the link between organizational social capital and work-home conflict in health professionals.

DESIGN

This issue was investigated using a cross-sectional study conducted in 2013.

PARTICIPANTS AND SETTING

Data from questionnaires completed by physicians and nurses (n=1733) were linked with structural data from 66 neonatal intensive care units in Germany.

METHODS

Using multi-level analyses, we investigated associations between organizational social capital at the ward level and work-home conflict at the level of individual employees, taking into account additional structural and individual characteristics.

RESULTS

Employees on wards with greater social capital reported significantly less work-home conflict. Our results support the hypothesis that organizational social capital is an important collective resource.

CONCLUSION

As such, more attention should be given to establishing a good working atmosphere that fosters mutual trust, support and a 'sense of unity', and this should be encouraged in a targeted fashion.

Objective working hour characteristics and work-life conflict among hospital employees in the Finnish public sector study

This epidemiological cohort study, based on Finnish public sector data, investigated the associations between objective working hour characteristics and work-life conflict in day and shift work. The comprehensive data of hospital workers (n = 8 931, 92% women, average age 45 years), consisted of survey responses from 2012, linked with the payroll data of working hour characteristics from 91 days preceding the survey. Logistic regression analysis was used to investigate the associations between working hour characteristics and experiencing work-life conflict often/very often. The analyses were adjusted for age (< 39, 40-49 and >50 years), sex, level of education, marital status, number of small (0-6 years) and school-aged (7-18 years) children, and the overall stressfulness of the life situation. We also conducted stratified analyses of age and sex on the basis of significant interactions. Difficulties in combining work and life were more often associated with shift work without night shifts and shift work with night shifts than with day work (41% and 34 versus 27%; OR for shift work with night shifts 1.78, 95% CI 1.59-2.00, OR for shift work without night shifts 1.42, 95% CI 1.26-1.60). A high proportion (> 25%) of long (> 40h, (OR 1.26, 95% 1.14-1.39) and very long (> 48h, OR 1.31, 95% CI 1.15-1.49) weekly working hours were associated with work-life conflict, and in the stratified analysis, the latter was also true among women (OR 1.54, 95% CI 1.25-1.89). Of the unsocial working hour characteristics, a relatively large amount (> 10% of all shifts) of evening (OR 1.56, 95% CI 1.41-1.72) and night shifts (OR 1.46, 95%CI 1.32-1.61), a high proportion (> 25% of all shifts) of quick returns (< 11h) (OR 1.46, 95% CI 1.31-1.63), and weekend work (OR 1.44, 95% CI 1.31-1.58) were associated with work-life conflict. A large amount of single days off (> 25% of all days off) was associated with work-life conflict among men (OR 1.90, 95% CI 1.11-3.25), but not in the whole sample. When the two types of shift work were analyzed separately, shift work without night shifts and very long work weeks had higher odds (OR 1.47, 95% CI 1.20-1.80) of work-life conflict than shift work with night shifts. Conversely, weekend work and evening shifts had higher odds of work-life conflict among shift workers with night shifts (OR 1.74, 95% 1.55-1.96; (OR 1.57, 95% CI 1.40-1.77) than among those without night shifts. To conclude, this study shows that shift workers with and without night shifts more often have difficulties combining work and life than day workers. Several unsocial working hour characteristics, including long work weeks, evening and night shifts, weekend work, and quick returns, are associated with work-life conflict.

Work-family conflict and enrichment in nurses: between job demands, perceived organisational support and work-family backlash

AIM

This study investigated how work relationships (perceived organisational support, supervisor and co-worker work-family backlash) and job demands (workload, emotional dissonance) can interact with work-family conflict and work-family enrichment.

BACKGROUND

Despite the extensive literature on the work-family interface, few studies on the nursing profession have considered the role of job demands and work relationships, focusing on both the positive and negative side of the work-family interface.

METHOD

The study involved a sample of 500 nurses working in an Italian hospital. Hierarchical multiple regression analyses were used to test hypotheses.

RESULTS

Analyses showed that work-family conflict has a positive relationship with job demands and supervisor backlash, and a negative relationship with perceived organisational support. Work-family enrichment was found to have a negative relationship with job demands and a positive relationship with perceived organisational support. No significant relationships were found between work-family enrichment and both backlash dimensions.

CONCLUSION

The study confirmed the importance of promoting a balance between job demands and resources in order to create favourable conditions for work-family enrichment and to prevent work-family conflict.

IMPLICATIONS FOR NURSING MANAGEMENT

The findings suggest that it may be advisable for health-care organisations to invest in measures at individual, team and organisational levels, specifically in training and counselling for nurses and supervisors.

Work–family conflict based on strain: The most hazardous type of conflict in Iranian hospitals nurses

Orientation: Work and family conflicts continuously and negatively affect employees’ performance. Previous research has mostly studied the impact of the two distinct dimensions of work–family conflict (WFC) and family–work conflict (FWC) on health outcomes, whereas the impact of more specific dimensions of these two general types of conflict on health outcomes is little known. Therefore, we now need to also measure the impact of more specified types of these conflicts on health outcomes.Research purpose: The purpose of this study was to propose a causal model of the effects of six different types of WFC (time, strain and behaviour) and FWC (time, strain and behaviour) on the mental and physical health of hospital nurses to identify the most hazardous type of conflict they faced.Motivation for the study: This research was conducted to outline which specific type of WFC or FWC is able to act as the strongest antecedent of mental and physical health in nurses.Research design, approach and method: Three hundred and eleven nurses from six hospitals were selected by simple random sampling. Data were collected using a Carlson WFC scale as well as an SF-36 mental–physical health scale based on a cross-sectional research design. The data were analysed using structural equation modelling and SPSS.Main findings: The final model showed that, firstly, the effects of WFC types (time, strain and behaviour) on health outcomes were much greater than the effects of FWC types (time, strain and behaviour). Secondly, WFC and FWC based on strain were stronger predictors of health outcomes. Finally, strain-based WFC was identified to be the most hazardous type of conflict in our study.Practical implications: These findings can be employed by hospital managers to block all the potential factors that may increase strain-based WFC in the workplace. Moreover, this study helps hospitals to use special educational programs directed at reducing strain-based WFC.Contribution/value-add: This research clearly revealed that a specific type of WFC may more likely influence the health situation of nurses.Keywords: WFC-Based on Strain; mental health; physical health; hospital nurses

Attitudes toward child rearing in female clinical nurses working in three shifts

The balance between child-rearing and work may be one of the most challenging issues facing female clinical nurses, particularly those who work in three shifts. This study aimed to identify attitudes toward child-rearing in this particular cohort, female clinical nurses working three shifts. Q methodology, a research method concerned with individuals' subjective points of view, was used. Thirty-five selected Q statements from 51 participants were divided into a normal distribution using a nine-point bipolar scale, and the collected data were analyzed using the QUANL program. Three discrete factors emerged: Factor I: child-rearing is natural work (child-rearing and work are separate); Factor II: child-rearing is hard work (child-rearing and work are in conflict); and Factor III: child-rearing requires help from someone (child-rearing and work are balanced). The subjective viewpoints of the three identified factors can be applied to develop diverse strategies to support child-rearing in female clinical nurses.