Work engagement and workload as predictors of nurse burnout: Evidence from a national hospital survey in Slovakia

Abstract

Hospital nurses are exposed to sustained cognitive, emotional, and organizational demands that elevate the risk of burnout. This study tests whether work engagement functions as a protective factor, whereas workload constitutes a risk factor for nurse burnout in hospital settings. We conducted a national cross-sectional survey of registered hospital nurses in Slovakia across public and private hospitals between September and October 2024. Given a finite population of 31,395 registered nurses in 2024, the minimum required sample at 95% confidence and a 5% margin of error was approximately 380; we analyzed 500 valid responses. Data collection was conducted using a standardized questionnaire, distributed online via Google Forms and in paper form upon request. Standardized scales captured work engagement (A1–A17), workload (Z1–Z6), and self-reported burnout; data were analyzed using multiple linear regression. Participation was voluntary and anonymous, and all respondents provided informed consent. The model was statistically significant and explained 39.3% of the variance in burnout (F = 64.09; p < 0.001). Higher engagement predicted lower burnout (β = −0.591; p < 0.001), whereas higher workload predicted higher burnout (β = +0.945; p < 0.001). These findings indicate that strengthening work engagement and managing workload represent complementary, actionable levers to mitigate nurse burnout in hospitals. The study provides effect-size estimates from a national sample, clarifies the protective role of engagement while controlling for workload, and offers direct targets for hospital HR policy (e.g., autonomy, recognition, staffing, and process optimization).