Spirituality, Culture and Job Satisfaction in the Holistic Assessment of Nurses' Well-Being at Work: A Cross-Sectional Survey Study.

Background: Nurses' well-being at work has become a global concern due to persistent stressors such as staff shortages, shift work, emotional demands and limited autonomy. Most existing studies take a deficit-centred perspective, focussing on burnout or work stress and ignoring the complexity of holistic well-being. Aim: The aim of this study was to assess nurses' levels of well-being at work across six well-being domains and explore its relationship with job satisfaction, health status and functional limitations. Methods: A cross-sectional survey was conducted among 767 nurses working in various healthcare institutions in Slovenia. The six-dimensional well-being scale for nurses, which was translated and psychometrically validated for this study, was used to assess physical, emotional, intellectual, social, occupational and spiritual well-being. Results: The overall median score for nurses' well-being at work was 2.97 (on a scale of 1-5), slightly below the neutral midpoint (M = 3.00). Among the dimensions, physical (M = 3.12), emotional (M = 3.18) and spiritual (M = 3.21) were rated lowest, while social (M = 3.60) and occupational (M = 3.58) were rated highest. Nurses with long-term health conditions or activity limitations gave significantly lower scores for well-being in the physical, emotional and occupational domains (p < 0.001). Higher job satisfaction was positively correlated with general well-being (r s  = 0.327, p < 0.001). Age and length of service were weakly negatively correlated with several domains of well-being (p < 0.001). Conclusions: Nurses' well-being at work has many facets and is influenced by personal health, job satisfaction and professional context. A holistic model can highlight strengths and weaknesses that are often overlooked in traditional, burnout-centred approaches. Implications for Nursing Management: Nurse managers should incorporate well-being into HR policy through relationship-centred leadership, flexible working practises and values-led support. Interventions should include reflective spaces, mentoring and learning opportunities tailored to emotional, intellectual and spiritual development. Monitoring dimensions of well-being as a key performance measure can lead to sustainable improvements in healthcare.