A cross-sectional mixed-methods study of nurses' quality of working life in telenursing and care satisfaction comparing those participating in continuing professional development or not during the previous year.

Abstract

Background: Rapid changes in healthcare and digitalization underscore the importance of continuing professional development (CPD) in nursing. However, participation is often limited by high workloads, staffing shortages, and insufficient organizational support. Telenursing is a growing field with specific competence requirements, yet previous research indicates demanding working conditions and limited development opportunities. Further evidence is needed regarding CPD participation, its association with work-related outcomes, and nurses' perceived CPD needs.

Aim: The aim of the study was to compare nurse-rated quality of working life and satisfaction with given care among nurses working in telenursing services who had participated in CPD during the previous year and those who had not. A further aim was to explore nurses' preferences and perceived needs related to CPD activities.

Methods: A cross-sectional survey among nurses in Sweden's national healthcare advisory service (1177) measured quality of working life four instruments were used. Emotional thriving was measured using a brief four-item scale. Telenursing working conditions were assessed using a telenursing-specific instrument. Growth opportunities were measured with a six-item factor from the instrument Safety, Communication, Operational Reliability and Engagement and job satisfaction using the four-item Brief Index of Affective Job Satisfaction scale. Satisfaction with given care was measured using the eight-item Satisfaction with Given Care scale. Participation in continuing professional development (CPD) was assessed by self-reported number of CPD days during the past year, including none, and an open-ended question capturing desired areas of competence development.

Results: Nurses who had participated in CPD reported significantly higher emotional thriving, as well as higher ratings for management and collegial support and growth opportunities, compared with those not participating in CPD. No group differences were found regarding satisfaction with given care. Identified CPD needs included strengthened clinical knowledge, reflective and self-directed learning, and improved communication skills.

Conclusion: Participating in CPD during the previous year is associated with more positive work-related outcomes among telenursing nurses such as thriving, growth opportunities, better management and collegial support but not with nurse-sensitive outcomes such as nurse satisfaction with given care. Nurses described clear preferences and needs for clinically relevant, reflective, and self-directed professional development.

Clinical trial number: Not applicable.

Reporting method: This study adhered to the relevant EQUATOR guidelines for observational studies and was reported in accordance with the STROBE. See attached file STROBE_CPD.

Patient or public contribution: The research focused exclusively on healthcare professionals' experiences and working conditions; therefore, no patient-facing activities were included. However, the study was informed by prior literature and organizational feedback to ensure that the research questions were relevant to clinical practice and service delivery.