WELL-BEING AND SATISFACTION OF NURSES IN SLOVENIAN 
HOSPITALS: A CROSS-SECTIONAL STUDY
Mateja LORBER
1*
, Sonja TREVEN
2
, Damijan MUMEL
2
1
University of Maribor, Faculty of Health Sciences, Žitna ulica 15, 2000 Maribor, Slovenia
2
University of Maribor, Faculty of Economics and Business, Razlagova 14, 2000 Maribor, Slovenia
Received: Oct 2, 2019
Accepted: Jun 8, 2020 
Original scientific article
*Corresponding author: Tel. + 386 2 300 47 53; E-mail: mateja.lorber@um.si
10.2478/sjph-2020-0023 Zdr Varst. 2020;59(3):180-188
POČUTJE IN ZADOVOLJSTVO MEDICINSKIH SESTER  
V SLOVENSKIH BOLNIŠNICAH: PRESEČNA RAZISKAVA
Lorber M, Treven S, Mumel D. Well-being and satisfaction of nurses in Slovenian hospitals: a cross-sectional study.  
Zdr Varst. 2020;59(3):180-188. doi: 10.2478/sjph-2020-0023.
ABSTRACT
Keywords: 
hospitals, nurses, 
satisfaction, health
IZVLEČEK
Ključne besede: 
bolnišnice, medicinske 
sestre, zadovoljstvo, 
zdravje
Introduction: Well-being is one of the most important factors in whether nurses decide to remain in the nursing 
profession. This study aims to examine well-being and satisfaction among nurses working in Slovenian hospitals 
and to identify the related demographic factors.
Methods: This descriptive cross-sectional study uses standardised instruments. The sample included 640 nurses 
working in Slovenian hospitals. The difference between individual variables were analysed using the Mann-Whitney 
and Kruskal-Wallis tests. 
Results: Nurses self-assessed their satisfaction and well-being as moderate. Forty-seven per cent of nurses were 
satisfied with their job, 49% assessed their psychological well-being as good, 52% were often exposed to stress 
at the workplace and 30% were always exposed to stress at the workplace. Levels of job satisfaction (p=0.031), 
psychological well-being (p=0.029) and subjective well-being (p=0.014) were found to differ significantly according 
to level of education, while levels of job satisfaction (p=0.005), life satisfaction (p<0.001), psychological well-
being (p<0.001) and subjective well-being (p<0.001) were also found to differ according to years of nursing service 
and from hospital to hospital (p<0.001). 
Conclusions: The key finding of the study is that nurses are moderately satisfied with their work and life and that 
they display moderate levels of psychological and subjective well-being. Hospitals can be successful and achieve 
the goals of the organisation if their employees are satisfied with work and enjoy good levels of well-being. 
Hospital management have to recognise the importance of ensuring that nurses and other employees are satisfied 
and healthy.
Uvod: Počutje medicinskih sester je eden najpomembnejših dejavnikov odločitve, ali ostanejo zaposlene v 
zdravstvu ali ne. Namen raziskave je bil ugotoviti stopnjo dobrega počutja in zadovoljstva medicinskih sester, ki 
delajo v slovenskih bolnišnicah, ter prepoznati nekatere povezane demografske dejavnike. 
Metode: Uporabljena je bila opisna presečna raziskava in standardizirani instrumenti. V vzorec je bilo vključenih 
640 medicinskih sester iz slovenskih bolnišnic. Razlike med posameznimi spremenljivkami so bile analizirane s 
testoma Mann-Whitney in Kruskal-Wallis. 
Rezultati: Medicinske sestre so samoocenile svoje zadovoljstvo in počutje kot zmerno. 47 % medicinskih sester je 
zadovoljnih s svojim delom, 49 % pa je svoje psihološko počutje ocenilo kot pozitivno. 52 % medicinskih sester je 
pogosto in 30 % medicinskih sester je vedno izpostavljenih stresu na delovnem mestu. Glede na stopnjo izobrazbe 
so bile ugotovljene statistično pomembne razlike v zadovoljstvu z delom (p = 0,031), psihološkem (p = 0,029) in 
subjektivnem počutju (p = 0,014). Statistično pomembne razlike so bile ugotovljene pri zadovoljstvu z delom (p = 
0,005), zadovoljstvu z življenjem (p < 0,001), psihološkem (p < 0,001) in subjektivnem počutju (p < 0,001) glede na 
leta delovnih izkušenj v zdravstveni negi in upoštevajoč različne bolnišnice (p < 0,001). 
Zaključki: Ključna ugotovitev raziskave je zmerno zadovoljstvo z delom in življenjem ter zmerno dobro psihološko 
in subjektivno počutje medicinskih sester. Bolnišnice so lahko uspešne in dosegajo organizacijske cilje, če so tudi 
medicinske sestre zadovoljne z delom in se dobro počutijo. Vodstvo v bolnišnicah mora prepoznati pomen skrbi za 
zadovoljne in zdrave medicinske sestre ter tudi ostale zaposlene v bolnišnici.
180
© National Institute of Public Health, Slovenia. 

1 INTRODUCTION
Healthcare systems face a shortage of nurses and 
increasing demands for patient care (1). The work-related 
demands on nurses are high (2) and their work is emotional 
and physically demanding (3). Nursing is becoming an 
increasingly stressful occupation (4), with nurses having 
to ensure high standards of quality and handle complex 
situations effectively (5). 
In the workplace context, the concept of well-being has 
different meanings across organisations and countries. 
While there are many definitions of well-being, there 
are two main concepts, as measured by subjective and 
psychological well-being. There is no significant degree 
of differentiation between the definitions of the two 
concepts, with both sharing a similar conceptual structure 
(6). Subjective well-being is the subjective assessment of 
life satisfaction, and is a combination of the individual’s 
positive and negative moods and emotions (7). At the 
same time, some authors (7) have noted that subjective 
well-being is multidimensional, that it is subject to 
cultural differences, and that it has beneficial effects on 
health and social relationships. Psychological well-being is 
equated with positive human functioning and defined by 
six factors: accepting oneself, mastering the environment, 
positive relationships, personal growth, purpose in life, 
and autonomy. The psychological well-being model has 
been used to study relationships between well-being 
and personality traits, mental and physical health, 
healthy ageing, family and occupational experiences, and 
neurological processes (8).
Well-being is one of the most important factors in whether 
nurses decide to remain in the profession (9), as well as 
on nurses’ engagement with work and on burnout beyond 
the effects of quantitative job demands and control (10). 
Employees are characterised as enjoying good well-being 
when they are satisfied with their work and organisation 
(11) and are more committed and affiliated (12). People 
with good well-being are more optimistic, more resilient 
to problems, and have a stronger belief in their ability to 
handle things (13). Some studies (14–16) have found that 
nurses’ psychological distress and well-being could impact 
on quality of care and patient safety.
Life satisfaction is a general assessment of emotions and 
attitudes about an individual’s life at a certain point. It 
constitutes the judgement that a person makes about their 
life, and it is the most extensive construct for assessing 
subjective well-being (17). Greater life satisfaction is 
associated with organisational results, such as greater 
career satisfaction, organisational commitment and job 
satisfaction (18). Most definitions of job satisfaction tend 
to focus on how employees feel and think about their 
work. These definitions are very similar to those of life 
satisfaction, and involve emotional states, feelings, 
affective responses and cognitive evaluations of work (19).
The basic condition for the successful management of 
employees in an organisation is reflected in support of high 
motivation and the satisfaction of employees at different 
ages (20). Research has shown that job satisfaction is 
associated with productivity (21), quality of patient care 
(22) and reduced staff turnover (23). 
Given the great importance of monitoring and ensuring 
employees’ well-being, which is associated with many 
positive outcomes for the individual (12, 13), for the 
organisation (9, 10) and for the patient (14–16), we 
decided that the study would aim to examine well-being 
and satisfaction among nurses in Slovenian hospitals and 
to identify the related demographic factors. While some 
studies carried out in various healthcare organisations have 
examined nurses’ job satisfaction, there has not yet been 
a study of the factors determining nurses’ psychological 
and subjective well-being in Slovenia.
2 METHODS
2.1 Study and Data Collection
A descriptive cross-sectional study was used. All Slovenian 
public hospitals with internal medicine and surgical 
departments were invited to participate in the study 
(N=12). Eight hospitals confirmed participation. The 
study included a convenience sample: nurses who had 
completed secondary education or higher, and who worked 
at internal or surgical departments in eight Slovenian 
hospitals. According to the Health Statistical Yearbook 
(24), which is the Slovenian statistical yearbook for 
health, a total of 8,787 nurses work in Slovenian hospitals. 
According to information supplied by the management of 
the participating hospitals, 3,402 nurses were working at 
internal medicine and surgical departments. To ensure 
a representative sample that accurately reflected the 
characteristics of the study group, we decided to include 
30% of all nurses from the participating hospitals. A total 
of 1,100 (32%) questionnaires were distributed: 85 were 
sent to mid- and unit-level head nurses and 1,015 were 
sent to other nursing staff. Questionnaires for head nurses 
were sent only to those who occupied a leading position 
in a department or unit, i.e. purposive sampling was used. 
A total of 1,100 hospital nurses received an invitation for 
participation, instructions, a guarantee of anonymity, and 
an envelope with a stamp and a return address (that of 
the researcher). The response rate was 58% (640), which 
represents 18.8% of the nurses working at the hospitals 
included in the study.
2.2 Measures
The structured questionnaire included demographic 
questions (gender, level of education (secondary; high, 
university/master level); job position (leader, other 
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employees)) and 115 questions related to job and life 
satisfaction, basic need satisfaction, and psychological and 
subjective well-being. Job satisfaction was determined 
by 15 items (25) and related to different dimensions of 
the work environment and the characteristics of work. 
Items were rated on a six-point Likert scale. The scale 
points were: 1 “completely unsatisfied”, 2 “unsatisfied”, 
3 “slightly unsatisfied”, 4 “slightly satisfied”, 5 “satisfied” 
and 6 “completely satisfied”. The sum of the scores created 
an overall image of job satisfaction, with higher scores 
indicating a higher level of job satisfaction. The sum of 
whole scale ranged from 15 to 90. Cronbach’s alpha was 
0.943. The satisfaction of participants’ basic needs was 
assessed using the Deci and Ryan Basic Need Satisfaction 
questionnaire (26). The questionnaire contains 21 items 
related to three dimensions of subjective well-being: 
competency (Cronbach’s α 0.942), autonomy (Cronbach’s 
α 0.963) and relatedness (Cronbach’s α 0.967). Items were 
rated on a six-point Likert scale. The scale points were: 1 
“completely disagree”, 2 “disagree”, 3 “slightly disagree”, 
4 “agree”, 5 “agree” and 6 “completely agree”. The 
sum of the scores created an overall image of a person’s 
experiences of the satisfaction of three needs (autonomy, 
competence, relatedness). Higher scores indicated higher 
levels of basic need satisfaction. The sum of the whole 
scale ranged from 21 to 126. Cronbach’s alpha was 0.984. 
Subjective well being was assessed using indicators of 
subjective well-being: the Positive Affect Negative Affect 
Schedule (PANAS) (27) and the Satisfaction with Life Scale 
(28). PANAS was designed to assess the affective dimension 
of subjective well-being, and consists of ten positive and 
ten negative moods in the past month. Items were rated 
on a six-point Likert scale. The scale points were: 1 “not 
at all/never”, 2 “slightly”, 3 “a little”, 4 “moderately”, 
5 “quite a bit” and 6 “very much/extremely”. On the 
positive and negative mood scale, the scores ranged from 
10 to 60, with higher scores representing a higher level of 
positive/negative affect. Cronbach’s alpha was 0.944 for 
positive affect and 0.646 for negative affect. Participants 
evaluated their satisfaction with life using the Satisfaction 
with Life Scale Five items were rated on a six-point Likert 
scale. The scale points were: 1 “completely disagree”, 
2 “disagree”, 3 “slightly disagree”, 4 “slightly agree”, 5 
“agree” and 6 “completely agree”. The sum of the scores 
created an overall image of life satisfaction, with higher 
scores indicating a higher level of life satisfaction. The sum 
of the whole scale ranged from 5 to 30. Cronbach’s alpha 
was 0.956. Subjective well-being is measured as a “sum of 
life satisfaction plus positive affect minus negative affect” 
(29). Higher scores indicated a higher level of subjective 
well-being. The sum of the whole scale ranged from 5 
to 30. Psychological well-being was assessed using the 
Psychological Well-Being Scale (30). The questionnaire 
contains 54 items. Nine statements relate to each of the 
six dimensions of psychological well-being: accepting 
oneself (Cronbach’s α 0.978), positive relationships with 
others (Cronbach’s α 0.951), autonomy (Cronbach’s α 
0.969), environmental management (Cronbach’s α 0.957), 
meaning of life (Cronbach’s 0.929) and personal growth 
(Cronbach’s 0.919). Items were rated on a six-point Likert 
scale. The scale points were: 1 “completely disagree”, 
2 “disagree”, 3 “slightly disagree”, 4 “slightly agree”, 5 
“agree” and 6 “completely agree”. The sum of the scores 
created an overall image of psychological well-being, with 
higher scores indicating a higher level of psychological 
well-being. The sum of the whole scale ranged from 54 to 
324. Cronbach’s alpha was 0.991. For better understanding 
average values transformed the ratio variable into 
categorical. Six possible ratings were transformed into 
two categories. In the first category combined ratings 1, 2 
and 3 related to dissatisfaction/disagreement, while into 
the second category combined 4, 5 and 6, which related 
to satisfaction/agreement. The Slovenian version of all 
the English-language questionnaires was developed using 
a translation–back-translation procedure. The English-
language version was translated into Slovenian and 
then back-translated blindly into English by a Slovenian 
translator. The Slovenian translator then checked the 
equivalence of the English version of the instruments. 
The items of the Slovenian instrument were formulated 
with the same contents as the items in the original 
instrument. Four nurses and four head nurses held group 
conversations to verify whether the Slovenian version of 
the questionnaires was appropriate. They were asked 
to complete the instrument and to identify those items 
whose content was unclear. This check revealed a need 
for several items to be clarified.
2.3 Statistical Analysis
Univariate and bivariate analyses were used. The partial 
and final scores were compared to the total score of each 
questionnaire. A Kolmogorov-Smirnov test confirmed 
the impression from a visual inspection that the scores 
for all studied variables was not normally distributed 
(p<0.001). Results were presented via the Median (Med) 
and interquartile range (IQR). Differences between 
individual variables were analysed using the Mann-
Whitney and Kruskal-Wallis tests. A p-value of <0.05 was 
considered to be statistically significant. All the analyses 
were conducted using SPSS (Statistical Package for Social 
Sciences Program), version 24.0.

3 RESULTS
A total of 640 nurses took part in the study: 346 (54%) 
from surgical departments and 294 (46%) from internal 
medicine departments. A total of 153 nurses (24%) were 
under 30, 410 (64%) were between 30 and 50, and 77 
(12%) were over 50. The average age was 40.6 years. Forty 
nurses (7%) had less than 5 years’ experience in nursing, 
134 (21%) had 5–10 years’ experience, 218 (33%) had 11-20 
years’ experience, 128 (20%) had 21–30 years’ experience, 
and 120 (19%) had more than 31 years’ experience. 
Twenty-six per cent (163) had one or more chronic non-
communicable diseases, 18% (110) were sometimes 
exposed to stress, 52% (334) were often exposed to stress, 
30% (194) were always exposed to stress at the workplace, 
and 82% (525) self-assessed that they managed stress. 
Nurses’ assessed their job satisfaction (Med=45; IQR=36) 
and life satisfaction (Med=15; IQR=16) as moderate. Their 
psychological (Med=146; IQR=106) and subjective well-
being (Med=18; IQR=14) was also moderate. 47% of nurses 
were satisfied with their job, 51% were satisfied with their 
life, 49% assessed their psychological well-being as good, 
and 47% assessed their subjective well-being as good. 
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The percentage of those who were always exposed to 
stressful situations rose with level of education from 
37.9% to 47.1%, as did job satisfaction (Med=40; IQR=36 
to Med=49; IQR=34),life satisfaction (Med=15; IQR=16 to 
Med=16; IQR=14), basic need satisfaction (Med=61; IQR=67 
to Med=83; IQR=53) psychological well-being (Med=130; 
IQR=108 to Med=197, IQR=88) and subjective well-being 
(Med=17; IQR=15 to Med=20; IQR12).  Levels of exposure to 
stress (p<0.001), job satisfaction (p=0.031), psychological 
well-being (p=0.023) and subjective well-being (p=0.014) 
were found to differ significantly according to level of 
education (Table 1).
The proportion of those who estimated that their work 
was always stressful increased in line with years of nursing 
service from 11.1% to 39.4%, while the proportion of those 
who managed stress fell from 85.5% to 76%. Life satisfaction 
(Med=24; IQR=13 to Med=11; IQR=15), job satisfaction 
(Med=54; IQR=18 to Med=41; IQR=40), psychological well-
being (Med=211; IQR=44 to Med=121; IQR=92),subjective 
well-being (Med=25; IQR=18 to Med=13; IQR=16) and basic 
need satisfaction (Med=100; IQR=50 to Med=51; IQR=60) 
all decreased with years of service. Statistically significant 
differences in levels of exposure to stress (p=0.003), 
life satisfaction (p<0.001), job satisfaction (p=0.005), 
psychological well-being (p<0.001) and subjective well-
being (p<0.001) were found in relation to years of service 
(Table 2).
Table 1. Differences according to level of education.
Legend: Med – median; IQR – interquartile range; p – statistical significance
Exposure to stress 
(range from 1 to 4)
Job satisfaction 
(range from 1 to 6)
Life satisfaction (LS 
(range from 1 to 6)
Psychological well-being 
(range from 1 to 6)
Basic need satisfaction 
(range from 1 to 6)
Subjective well-being 
(range from 1 to 6)
2.5(1) 
40(36) 
15(16) 
130(108) 
61(67) 
17(15)
Variables/level of 
education
Secondary
Med (IQR)
2.5(1) 
40(36) 
15(16) 
130(108) 
61(67) 
17(15)
High
Med (IQR)
3.5(2) 
49(34) 
16(14) 
197(88) 
83(53) 
20(12)
University/
Master’s
Med (IQR)
25.021 
10.306 
8.006 
10.489 
7.763 
12.420
Kruskal-Wallis H
<0.001 
0.031 
0.091 
0.023 
0.092 
0.014
p

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184
While women rated their life satisfaction (Med=15; 
IQR=16), job satisfaction (Med=45; IQR=36), basic need 
satisfaction (Med=68.5; IQR=60), psychological well-
being (Med=146.5; IQR=108) and subjective well-being 
(Med=18; IQR=14) higher than men, the differences were 
not significant (Table 3). More women than men (32% vs. 
27%) assessed that they were always exposed to stress, 
and 89% of men and 79% of women self-assessed that they 
managed stressful situations. Significant differences in 
terms of gender were only found in the management of 
managing stressful situations (Z=-1.955; p=0.048).
Table 2.
Table 3.
Table 4.
Differences in relation to years of service.
Differences according to gender.
Differences in relation to job position.
Exposure to stress
Job satisfaction
Life satisfaction
Psychological well-being
Basic need satisfaction
Subjective well-being
Exposure to stress
Job satisfaction
Life satisfaction
Psychological well-being
Basic need satisfaction
Subjective well-being
Exposure to stress
Job satisfaction
Life satisfaction
Psychological well-being
Basic need satisfaction
Subjective well-being
3(1)
54(18)
24(13)
211(44)
100(50)
25(18)
3(1)
45(36)
15(16)
146(108)
68.5(60)
18(14)
3(1)
40(35)
15(16)
137(114)
63(64)
16(15)
3(1)
50(30)
22(14)
196(108)
90(61)
22(14)
3(1)
35(36)
13(16)
133(105)
57.5(64)
15.5(16)
3(1)
60(13)
20(7)
181(66)
91(35)
22(5)
3(1)
44(32)
15(14)
134(173)
63(58)
16(13)
0.598
1.082
1.307
1.280
0.777
1.489
-0.676
-6.460
-1.190
-0.333
-0.614
-2.966
3(0)
48(36)
18(15)
167(104)
82(58)
20(14)
22975
22199
21683
19836
21141
20959
20193
11469.5
19028.5
16666.5
18733
15637
4(1)
41(40)
11(15)
121(92)
51(60)
13(16)
0.550
0.279
0.191
0.201
0.437
0.136
0.499
<0.001
0.234
0.739
0.539
0.003
16.763
17.945
28.492
28.536
23.994
30.663
<5
Med (IQR)
Female
Med (IQR)
Other nurses
Med (IQR)
Legend: Med – median; IQR – interquartile range; p – statistical significance
Legend: Med – median; IQR – interquartile range; p – statistical significance
Legend: Med – median; IQR – interquartile range; Z – test value; p – statistical significance
6–10
Med (IQR)
Male
Med (IQR)
Head nurses
Med (IQR)
11–20
Med (IQR)
Mann-
Whitney U
Mann-
Whitney U
21–30
Med (IQR)
Z
Z
>30
Med (IQR)
p
p
Kruskal-
Wallis H
Variables/years of service
Variables/gender
Variables/job position
0.003
0.005
<0.001
<0.001
<0.001
<0.001
p
Head nurses assessed that their work was always stressful 
in 37.3% of cases (other nurses in 29.4% of cases), while 
of 84% of head nurses and 78% of other nurses assessed 
that they managed stressful situations. Head nurses rated 
their job satisfaction (Med=60; IQR=13), life satisfaction 
(Med=20; IQR=7), basic need satisfaction (Med=91; 
IQR=35), psychological well-being (Med=181; IQR=66) and 
subjective well-being (Med=22; IQR=5) higher than other 
nurses. Significant differences in relation to job position 
were identified only in job satisfaction (p<0.001) and 
subjective well-being (p=0.003) (Table 4).

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185
Table 5. Differences in relation to presence of chronic disease.
Exposure to stress
Job satisfaction
Life satisfaction
Psychological well-being
Basic need satisfaction
Subjective well-being
3(1)
45.5(36)
17.5(15)
168(108)
80(61)
19.5(13)
3(1)
36(59)
12(16)
122.5(95)
56(59)
14.5(15)
-3.168
-2.182
-3.220
-1.945
-2.355
-3.016
33230
34795.5
32395
30728.5
31634.5
31610
0.002
0.029
0.001
0.049
0.019
0.003
Without
Med (IQR) 
Legend: Med – median; IQR – interquartile range; Z – test value; p – statistical significance
With 
Med (IQR)
Mann-
Whitney U
Z p Variables/chronic disease
Nurses with a chronic non-communicable disease assessed 
their work as stressful in 41% of cases (26% of cases for 
those without a chronic non-communicable disease). 
Nurses with a chronic non-communicable disease 
rated their satisfaction with life (Med=12; IQR=16), job 
satisfaction (Med=36; IQR=59), basic need satisfaction 
(Med=56; IQR=59), psychological well-being (Med=122.5; 
IQR=95) and subjective well-being (Med=14.5; IQR=15) 
lower than those without a non-communicable chronic 
disease. Significant differences between nurses with and 
without a chronic non-communicable disease were found 
in relation to exposure to stress (p=0.002), job satisfaction 
(p=0.029), life satisfaction (p=0.001), psychological well-
being (p=0.049), basic need satisfaction (p=0.019) and 
subjective well being (p=0.003) (Table 5).
The proportion of employees who self-assessed that 
they were always exposed to stress and that they 
managed their stressful situations varied from hospital 
to hospital (between 9% and 53% and between 70 
and 92% respectively). Again varying from hospital to 
hospital, nurses’ assessment of life satisfaction ranged 
from Med=11(IQR=8) to Med=25(IQR=5), assessment of 
subjective well-being between Med=13.5(IQR=16) to 
Med=25(IQR=4.7), assessment of job satisfaction between 
Med=30(IQR=23) to Med=64(IQR=10), assessment of 
basic need satisfaction between Med=50(IQR=37) to 
Med=112(IQR=6) and assessment of psychological well-
being between Med=116(IQR=36) to Med=222(IQR=35). 
Significant differences were found between hospitals in 
relation to exposure to stress (p<0.001), job satisfaction 
(p<0.001), life satisfaction (p<0.001), psychological well-
being (p<0.001), basic need satisfaction (p<0.001) and 
subjective well-being (p<0.001).
4 DISCUSSION
The key finding of this study is that nurses in Slovenian 
hospitals are moderately satisfied with their work and 
life, and also display moderate levels of psychological 
and subjective well-being. While other studies (31, 32) 
have also found nurses’ psychological well-being to be 
moderate, Bourgault et al. (33) found low well-being 
among emergency nurses, as did Atanes et al. (34) among 
nurses at primary level and Oates et al. (35) among 
mental health nurses. In contrast to our results (Med=146; 
IQR=106), high well-being was identified (36) among 
mental health workers (285.6±41.7) and also non-health 
workers (269.7±44.07) in Australia.
Female nurses experienced higher psychological and 
subjective well-being, which is comparable with study 
(37). As in other studies (38, 39), no statistically significant 
gender-related differences were found. Results showed 
that nurses were often (and some of them always) exposed 
to stress, which is in line with other studies (34, 40). 
Karimi et al. (41) noted that nurses’ predicted well-being 
was an important factor in stress-related presenteeism.
Nurses with less than five years’ nursing experience had the 
highest levels of job and life satisfaction (self-assessed), 
as well as the highest psychological and subjective well-
being, compared to nurses with more years of nursing 
experience. Nurses’ well-being decreased with years of 
service, which is in line with study (36). However, study 
(37) found that well-being increased with years of service. 

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It was found that head nurses were more satisfied with 
their job than other nurses, and that job satisfaction 
decreased with years of service, which is in line with other 
studies (42, 43). Some studies (42-44) have also found 
that nurses have moderate levels of job satisfaction. Our 
findings regarding differences in well-being connected to 
job position and years of service accord with other studies 
(33, 34).
Differences in job satisfaction, psychological and 
subjective well-being were found to be conditioned 
by level of education, i.e. nurses with a higher level of 
education were more satisfied with their job. This is in 
line with other studies (45, 46). Moreover, job satisfaction 
is positively associated with greater self-efficacy (47), 
engagement with work (48), occupational health (4) 
and job performance (21) on the part of nurses. There 
is also evidence of an association between nurses’ job 
satisfaction and patient satisfaction (48–50). In addition 
to stress, job satisfaction is also strongly associated with 
general health (4, 51, 52). Nurses who suffered from 
a chronic non-communicable disease rated their job 
satisfaction, life satisfaction, psychological well-being and 
subjective well-being lower than nurses who did not suffer 
from such diseases. Study (53) found that satisfaction with 
life and health was conditioned by the presence of chronic 
disease, with poor levels of life satisfaction being linked 
to undesirable health outcomes, including the elevated 
risk of chronic disease and death (54).
Differences in the level of nurses’ satisfaction and well-
being from hospital to hospital can be explained by the 
results of other studies, which highlighted differences in 
organisational culture (55), organisational support (56) 
and leadership style (14). It is important for management 
to realise that well-being is of great importance not only 
to employees, as it promotes better health, positive 
self-esteem, better relationships with other people and 
resilience (7, 57), but also to the organisation (11, 12). 
Some studies (14-16) have found a significant relationship 
between nurses’ well-being and the quality of patient 
care - for example, Hall et al., in the systematic review 
contained in (58), found that 16 of the 27 studies 
established a significant correlation between poor well-
being and reduced patient safety. As they have a serious 
impact on work productivity, patient care, staff efficiency 
and turnover rates, the relationships between work-
related stress, job satisfaction, well-being and the general 
health of nurses need to be better understood (4).
Well-being is important for nurses, who face the challenge 
of balancing job stress and patient care outcomes without 
succumbing to emotional exhaustion. The results were 
presented to the management of each participating 
hospital in line with the interest they expressed, with the 
results from the specific hospital also being presented 
in relation to the overall results. With this, hospital 
management is able to identify the “real” situation and to 
try to recognise the importance of monitoring employees’ 
job satisfaction and well-being for better employee health 
and the achievement of better outcomes. The practical 
implications of the results suggest that interventions 
designed to promote positive well-being may help 
improve nursing environments, which in turn may result in 
improved approaches to safety and quality and improved 
nursing outcomes. 
Although these findings are notable, several limitations 
should be acknowledged. It is noteworthy that the study 
was cross-sectional rather than longitudinal. While the 
sample is not balanced in terms of nurses’ educational 
achievements and gender, this does reflect the actual 
structure of nursing in Slovenian hospitals. The researcher 
was not available during the research process in the 
participating hospitals, which meant that the respondents 
did not receive assistance if they did not understand an 
item and were not able to obtain additional explanations. 
It is possible that the respondents were overly positive 
or negative with regard to satisfaction and well-being. 
We therefore have to be careful when generalising the 
findings. Future research should examine longitudinally 
the possible interaction between well-being, the nursing 
practice environment and patient safety outcomes.
5 CONCLUSION
The key finding of this study is that nurses in Slovenian 
hospitals are moderately satisfied with their work and life, 
and display moderate levels of psychological and subjective 
well-being, and that the differences are conditioned 
by level of education, years of service, the presence 
or otherwise of chronic disease and the organisation in 
which they work. In a constantly changing health system, 
hospital management have to recognise the importance 
of satisfied and healthy employees. Hospitals can be 
successful and achieve the goals of their organisations if 
employees are satisfied with their work and enjoy positive 
well-being. Management policies and practices that aim 
to implement changes to improve employees’ well-being 
need to be focused on enhancing nurses’ well-being so 
that nurses remain in the profession in greater numbers. 
Employers must monitor job satisfaction and take periodic 
steps to ensure well-being and health - indeed, this is the 
only way that organisations can adapt to the individual 
and achieve greater efficiency and better quality. 
Poor well-being associated with poorer patient safety has 
significant implications for policy-makers and management 
in healthcare settings. Healthcare organisations must 
provide a work environment that fosters nurses’ well-
being and safeguards against burnout, thus ensuring that 
patients are provided with a safe service.

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Positive Organisational Psychology suggests that 
employees’ health is an important goal in itself and one 
that management should include in its organisational 
policy. When establishing the level of job satisfaction, 
well-being and health, we must focus on how employees 
feel about their work and about personal relationships 
at the workplace, and on the way management has an 
impact on employees.
CONFLICTS OF INTEREST
The authors declare that no conflicts of interest exist.
FUNDING
The research received a non-specific grant from any 
funding agency in the public, commercial or not-for profit 
sectors.
ETHICAL APPROVAL
Research includes human data processed in accordance 
with the Declaration of Helsinki and approved by the 
National Medical Ethics Committee of the Republic of 
Slovenia (No 157/09/13). Before the interviews, the 
nature and the purpose of the study were explained 
and participants were informed that participation in the 
study was voluntary and anonymous. Participants gave 
their verbal consent before the study. The design of the 
study and the interviews with prior verbal consent were 
approved by the National Medical Ethics Committee of the 
Republic of Slovenia.
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