The Relationship Between Job Satisfaction and Individualised Care Provision in Intensive Care Units: A Structural Equation Modelling Approach

Abstract

Background: Individualised care, a key element of person-centred care, requires tailoring nursing interventions to patients' unique needs and preferences. In intensive care units (ICUs), this approach is challenged by technical environments and limited patient communication. Evidence suggests that nurses' ability to deliver such care may depend on workplace conditions and job satisfaction; however, the mechanisms linking specific satisfaction factors with individualised care provision remain unclear. Aim: To examine the relationship between job satisfaction and the provision of individualised care among critical care nurses, testing whether different job satisfaction factors impact the practical application of person-centred care, that is: two dimensions of individualised care: (1) nursing activities supporting patient individuality and (2) nurses' perceptions of maintaining individuality in the care provided. Study Design: A secondary analysis was performed using data from a cross-sectional survey of 306 registered ICU nurses in Poland. Job satisfaction was measured with the Kuopio University Hospital Job Satisfaction Scale and individualised care with the Individualised Care Scale–Nurse. Data were analysed using structural equation modelling. Results: The final model showed excellent fit (χ2 (4) = 2.63, p = 0.622; χ2/df = 0.66; CFI = 1.000; RMSEA < 0.001; SRMR = 0.009) and explained 48.6% of the variance in individualised care actions and 46.6% in perceptions. Higher self-fulfilment, leadership, workplace autonomy and resource distribution were positively associated with individualised care activities, while professional development and motivating work organisation were negative predictors. Perceptions of maintaining individuality in care were positively influenced by self-fulfilment, leadership and resource distribution and negatively by professional development. Conclusions: Job satisfaction significantly shapes the delivery of individualised care in ICUs. Supportive leadership, professional fulfilment and fair resource allocation promote person-centred practice, whereas unmet expectations regarding professional development and organisational motivation may hinder it. Relevance to Clinical Practice: Creating person-centred work environments that enhance autonomy, recognition and meaningful professional growth can improve both nurse satisfaction and the quality of care.