A Three-Pillar Framework for Nurse Well-Being: An Integrative Review of Multilevel Strategies

IF 2.5 4区医学 Q2 NURSING

International Journal of Nursing Practice Pub Date : 2026-06-22 DOI:10.1111/ijn.70163

Rachell Nguyen

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引用次数: 0

Abstract

Aim

This study aimed to synthesize evidence on multilevel strategies that promote nurse well-being and resilience to support workforce sustainability.

Design

Integrative review was guided by Whittemore and Knafl's methodology.

Methods

Systematic searches of CINAHL, PubMed, Web of Science and MEDLINE identified 2485 records published between January 2002 and December 2025. After removing duplicates and screening titles and abstracts, 161 articles underwent full-text review. Sources addressing nurse well-being, burnout, resilience and mental health were assessed for eligibility. Study quality was appraised using the Johns Hopkins Evidence-Based Practice tool. Fifty-two primary research studies were retained for the results synthesis.

Results

Analysis revealed evidence organized within a three-pillar framework that integrates mental health promotion, burnout prevention and resilience building across individual, organizational and system levels. Unlike previous reviews focusing on single interventions, this framework shows that sustainable nurse well-being requires simultaneous, coordinated action across all three pillars. Evidence consistently identified adequate staffing, supportive leadership, and psychological safety as foundational enablers, with staffing adequacy showing the strongest associations with burnout reduction.

Conclusion

Nurse well-being requires integrated, multilevel solutions that combine individual skill development with organizational reform and supportive policy environments to ensure workforce sustainability.

Impact

This study provides actionable, evidence-based strategies for nursing leaders, educators and policymakers to foster healthy work environments that support nurse well-being, retention and quality patient care.

查看原文本刊更多论文

护士福祉的三支柱框架：多层次策略的综合回顾。

目的：本研究旨在综合有关促进护士福祉和弹性的多层次战略的证据，以支持劳动力的可持续性。设计：综合评价以Whittemore和Knafl的方法为指导。方法：系统检索CINAHL、PubMed、Web of Science和MEDLINE，检索2002年1月至2025年12月发表的2485篇文献。在删除重复和筛选标题和摘要后，161篇文章进行了全文审查。对涉及护士福祉、倦怠、复原力和心理健康的来源进行资格评估。使用约翰霍普金斯循证实践工具评估研究质量。52项初步研究被保留用于结果综合。结果：分析揭示了在三个支柱框架内组织的证据，该框架整合了个人，组织和系统层面的心理健康促进，倦怠预防和弹性建设。与以往侧重于单一干预措施的审查不同，该框架表明，可持续的护士福祉需要在所有三个支柱上同时采取协调一致的行动。证据一致表明，充足的人员配备、支持性领导和心理安全是基本的促成因素，而人员配备充足与减少职业倦怠的关系最为密切。结论：护士福祉需要综合的、多层次的解决方案，将个人技能发展与组织改革和支持性政策环境相结合，以确保劳动力的可持续性。影响：本研究为护理领导者、教育工作者和政策制定者提供了可操作的、基于证据的策略，以营造健康的工作环境，支持护士的福祉、保留和高质量的患者护理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Nursing Practice NURSING-

CiteScore

4.10

自引率

0.00%

发文量

审稿时长

3 months

期刊介绍： International Journal of Nursing Practice is a fully refereed journal that publishes original scholarly work that advances the international understanding and development of nursing, both as a profession and as an academic discipline. The Journal focuses on research papers and professional discussion papers that have a sound scientific, theoretical or philosophical base. Preference is given to high-quality papers written in a way that renders them accessible to a wide audience without compromising quality. The primary criteria for acceptance are excellence, relevance and clarity. All articles are peer-reviewed by at least two researchers expert in the field of the submitted paper.