Factors affecting the well-being of nurses in intensive care units
A systematic review
DOI:
https://doi.org/10.14528/snr.2026.60.Suppl.1.3327Keywords:
psychological resilience, burnout, occupational stress, spiritual well-being, critical care nursingAbstract
Introduction: The well-being of nurses in intensive care units (ICUs) is crucial for maintaining high-quality patient care and long-term workforce sustainability. Due to heavy workloads, moral distress, and emotional challenges, ICU nurses are at increased risk of burnout. The aim of this review is to analyse the factors affecting their emotional, mental, and spiritual well-being.
Methods: A systematic literature review was conducted following the PRISMA guidelines. The literature search was performed in the PubMed, CINAHL, and ScienceDirect databases for publications from 2015 to 2025. Included studies employed qualitative, quantitative, or mixed-method designs and focused on ICU nurses' well-being. The studies were analysed in accordance with the thematic analysis approach described by Braun and Clarke.
Results: Seven studies were included in the final analysis. Three core themes emerged: organisational support (e.g. workload, shift work, leadership culture), psychological stability (e.g. stress, burnout, team cohesion), and spiritual resilience (e.g. sense of meaning, inner stability, reflective practice). The interaction of these factors significantly affects nurses' professional resilience and job satisfaction.
Discussion and conclusion: Supporting ICU nurses' well-being requires a holistic approach that goes beyond addressing burnout. Integrated strategies are recommended, including psychological and spiritual support, improved working conditions, and sustainable institutional policies. The findings provide a foundation for further research and the development of interventions focused on enhancing nurses’ resilience and overall well-being.
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References
Adriaenssens, J., De Gucht, V., & Maes, S. (2015). Causes and consequences of occupational stress in emergency nurses, a longitudinal study. Journal of Nursing Management, 23(3), 346–358. https://doi.org/10.1111/jonm.12138 PMid:24330154
Al-Makhaita, H. M., Sabra, A. A., & Hafez, A. S. (2014). Predictors of work-related stress among nurses working in primary and secondary health care levels in Dammam, Eastern Saudi Arabia. Journal of Family & Community Medicine, 21(2), 79–84. https://doi.org/10.4103/2230-8229.134762 PMid:24987275; PMCid:PMC4073564
Alkery, B. M., Barbari, A. H. E., Al-Sahfi, H. A., Aljehani, S. S., Alsaied, Z. O. S., Alsalmi, S. F. T., Abadi, A. E., Alasmary, S. A. M., Alshaybani, A. H., & Alzahrani, F. S. (2024). The impact of shift work on nurses' mental health and job performance: A cross-sectional comparative study. Journal of International Crisis and Risk Communication Research, 7(1), 331–336. https://doi.org/10.63278/jicrcr.vi.1322
Garcia, C. L., Abreu, L. C. de, Ramos, J. L. S., Castro, C. F. de, Smiderle, F. R. N., Santos, J. A. D., & Bezerra, I. M. P. (2019). Influence of burnout on patient safety: Systematic review and meta-analysis. Medicina, 55(9), Article 553. https://doi.org/10.3390/medicina55090553 PMid:31480365; PMCid:PMC6780563
Hassan, E. A., & Elsayed, S. M. (2025). Exploring resilience in critical care nursing: A qualitative inquiry into continuous adaptation, collaborative unity, and emotional balance. BMC Nursing, 24(1), Article 238. https://doi.org/10.1186/s12912-025-02844-0 PMid:40033316; PMCid:PMC11877925
Heesakkers, H., Zegers, M., van Mol, M. M. C., & van den Boogaard, M. (2023). Mental well-being of intensive care unit nurses after the second surge of the COVID-19 pandemic: A cross-sectional and longitudinal study. Intensive & Critical Care Nursing, 74, Article 103313. https://doi.org/10.1016/j.iccn.2022.103313 PMid:36153185; PMCid:PMC9393155
Jarden, R. J., Sandham, M., Siegert, R. J., & Koziol-McLain, J. (2020). Intensive care nurses' well-being: A systematic review. Australian Critical Care, 33(1), 106–111. https://doi.org/10.1016/j.aucc.2018.11.068 PMid:30679048
Jennings, B. M. (2008). Work stress and burnout among nurses: Role of the work environment and working conditions. In Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Agency for Healthcare Research and Quality.
Keyes, C. L. M. (2002). The mental health continuum: From languishing to flourishing in life. Journal of Health and Social Behavior, 43(2), 207–222. https://doi.org/10.2307/3090197 PMid:12096700
Maslach, C. (2018). Burnout: A multidimensional perspective. In Professional burnout (pp. 19-32). CRC Press. https://doi.org/10.4324/9781315227979-3
Moreno-Mulet, C., Sansó, N., Carrero-Planells, A., López-Deflory, C., Galiana, L., García-Pazo, P., Borràs-Mateu, M. M., & Miró-Bonet, M. (2021). The Impact of the COVID-19 Pandemic on ICU Healthcare Professionals: A Mixed Methods Study. International Journal of Environmental Research and Public Health, 18(17), Article 9243. https://doi.org/10.3390/ijerph18179243 PMid:34501832; PMCid:PMC8431632
Murad, M. H., Asi, N., Alsawas, M. & Alahdab, F., 2016. New evidence pyramid. BMJ Evidence-Based Medicine, 21(4), 125–127. https://doi.org/10.1136/ebmed-2016-110401 PMid:27339128; PMCid:PMC4975798
Othman, S. Y., Hassan, N. I., & Mohamed, A. M. (2023). Effectiveness of mindfulness-based interventions on burnout and self-compassion among critical care nurses caring for patients with COVID-19: A quasi-experimental study. BMC Nursing, 22(1), Article 305. https://doi.org/10.1186/s12912-023-01466-8 PMid:37674145; PMCid:PMC10481566
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., McGuinness, L. A., … Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372, Article n71. https://doi.org/10.1136/bmj.n71 PMid:33782057; PMCid:PMC8005924
Rakhshan, M., Derakhshan, S., & Kalyani, M. N. (2024). The relationship between spiritual health and resilience of nurses with their compassionate care in intensive care units. Journal of Education and Health Promotion, 13, Article 377. https://doi.org/10.4103/jehp.jehp_939_23
See, K. C., Zhao, M. Y., Nakataki, E., Chittawatanarat, K., Fang, W. F., Faruq, M. O., Wahjuprajitno, B., Arabi, Y. M., Wong, W. T., Divatia, J. V., Palo, J. E., Shrestha, B. R., Nafees, K. M. K., Binh, N. G., Al Rahma, H. N., Detleuxay, K., Ong, V., Phua, J., & SABA Study Investigators and the Asian Critical Care Clinical Trials Group (2018). Professional burnout among physicians and nurses in Asian intensive care units: A multinational survey. Intensive Care Medicine, 44(12), 2079–2090. https://doi.org/10.1007/s00134-018-5432-1 PMid:30446797
Van Mol, M. M. C., Kompanje, E. J. O., Benoit, D. D., Bakker, J., & Nijkamp, M. D. (2015). The prevalence of compassion fatigue and burnout among healthcare professionals in intensive care units: A systematic review. PLOS ONE, 10(8), Article e0136955. https://doi.org/10.1371/journal.pone.0136955 PMid:26322644; PMCid:PMC4554995
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