How is work–family conflict linked to nurse-assessed patient safety among intensive care unit nurses? A serial multiple mediation analysis

Aim

The aim of this study was to test whether rumination and negative affectivity mediate the relationship between work–family conflict and nurse-assessed patient safety among intensive care unit nurses.

Background

Most intensive care unit nurses experience work–family conflicts that jeopardise patient safety. Although prior studies have explored the effect of work–family conflict on patient safety, few have investigated whether work–family conflict is associated with patient safety through rumination and negative affectivity among intensive care unit nurses.

Design

Cross-sectional study.

Methods

This study included 209 intensive care unit nurses from five general hospitals. The Work–Family Conflict Scale, the Ruminative Response Scale, the Positive and Negative Affect Schedule-Negative Affectivity, and three items indicating nurses’ perception of overall patient safety were used to gather data. Associations between work–family conflict, rumination, negative affectivity, and nurse-assessed patient safety were assessed using correlation and serial multiple mediation analysis.

Results

Work–family conflict, rumination, negative affectivity, and nurse-assessed patient safety were significantly correlated (p < 0.01). Work–family conflict can have not only a direct negative impact on the nurse-assessed patient safety (effect = −0.0234; standard error [SE] = 0.0116; 95% confidence interval [CI]: lower limit [LL] = −0.0464, upper limit [UL] = −0.0005) but also an indirect impact on nurse-assessed patient safety through three paths: the independent mediating role of rumination (effect = −0.0118; SE = 0.0063; 95% CI: LL = −0.0251, UL = −0.0006), the independent mediating role of negative affectivity (effect = −0.0055; SE = 0.0039; 95% CI: LL = −0.0153, UL = −0.0001), and the chain-mediating role of rumination and negative affectivity (effect = −0.0078; SE = 0.0031; 95% CI: LL = −0.0152, UL = −0.0027).

Conclusion

Our findings indicated that work–family conflict could influence nurse-assessed patient safety through increasing rumination and negative affectivity among intensive care unit nurses. Based on the results, interventions aimed at decreasing work–family conflict would be beneficial for intensive care unit nurses’ emotional stability and patient safety.