• Peter Van Bogaert, Sean Clarke, Riet Willems, and Mieke Mondelaers.
• Division of Nursing and Midwifery Science, University of Antwerp, Wilrijk, Belgium. peter_van_bogaert@hotmail.com
• J Clin Nurs. 2013 Jun 1; 22 (11-12): 1717-28.

Aims And ObjectivesTo examine relationships between practice environment ratings, workload, work engagement, job outcomes and assessments of quality of care in nursing personnel in psychiatric hospitals.DesignCross-sectional survey.BackgroundA broad base of research studies in health care reveals important links between work environment factors, staff burnout and organisational outcomes that merit examination in inpatient mental healthcare settings. Work engagement, a positively framed parallel construct for burnout, may offer an additional insight into the impacts of work on staff.MethodsA sample of 357 registered nurses (65·5%), licensed practical nurses (23·5%) and non-registered caregiver (10·6%) of two Belgian psychiatric hospitals were surveyed. A causal model was tested using structural equation modelling, whereby it was proposed that work engagement would be influenced by work environment factors and itself impact perceived quality of care and staff job outcomes such as job satisfaction and turnover intentions.ResultsAn adjusted model was confirmed. Practice environment features influenced staff vigour and dedication and demonstrated positive effects on job satisfaction, turnover intentions and perceived quality of care through their effects on absorption.ConclusionThe findings of this study suggest that work engagement is a likely direct consequence of practice environments that may ultimately have impacts on both staff and patient outcomes.Relevance To Clinical PracticeLeaders, nurse managers, clinicians as well as nurses themselves should be aware of the importance of work environments in mental healthcare facilities that favour engagement. Future efforts should focus on developing and sustaining practice environments that engage mental healthcare workers within interdisciplinary teams with the goal of creating a stable workforce possessing optimal possible knowledge, skills and abilities for delivering care.© 2012 Blackwell Publishing Ltd.

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