Unraveling the complexity of nurses’ quality of life: A Fuzzy-Set Qualitative Comparative Analysis (fsQCA) approach to the interplay of psychological, occupational, and social factors

Abstract

Aim This study aimed to explore the interplay among occupational stress, psychological distress, social support, burnout, and work-family conflict in relation to the quality of life (QOL) of nurses. Methods A total of 503 nurses from two tertiary-level hospitals participated in an online survey. Data were collected on psychological distress, occupational stress, social support, burnout, work-family conflict, and quality of life. Fuzzy-set Qualitative Comparative Analysis (fsQCA) was conducted to identify configuration pathways associated with high and low QOL, thereby providing a nuanced understanding of the causal complexity underlying these outcomes. Results Four configuration pathways were identified as conducive to high QOL: (H1) low burnout, low occupational stress, and high social support; (H2) low work-family conflict, low burnout, low occupational stress, and low psychological distress; (H3) high social support, low work-family conflict, low occupational stress, and low psychological distress; and (H4) high social support, low work-family conflict, low burnout, and low psychological distress. Conversely, two pathways were associated with low QOL: (L1) high occupational stress, high psychological distress, high work-family conflict, and low social support; and (L2) high occupational stress, high psychological distress, high work-family conflict, and high burnout. Conclusion Nurses’ QOL is critically influenced by occupational and psychological stressors, work-family conflict, and social support. Addressing these factors through targeted interventions may reduce burnout and psychological distress while enhancing well-being and job satisfaction.