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NCT Number: NCT07520058

Shortened Working Hours for Nurses in Elderly Care and Municipal Home Care - Work Environment, Work-life Balance & Well-being

Elderly care and municipal home care have and are facing several challenges with an increasing number of elderly people and fewer people of working age. In addition, welfare staff also have more sick days on average than other areas. Stress, mental ill health and intention to leave work are common. Furthermore, there is a national and international shortage of staff and especially a shortage of specialist nurses, e.g., elderly care and primary care. Strengthening the positive aspects will be central and creating good conditions for staff and thus hopefully also better care and welfare. A sustainable working life where the staff thrive, experience learning, meaning, well-being, good structural conditions, work-life balance and want to stay in the long term.

In one of the municipalities in this research project, they will introduce shortened working hours for registered nurses. A shortened working hours (reduced full-time standard by 3.25 hours/week with maintained salary) during a one-year pilot project for nurses in elderly care and municipal home care. Current full-time standard 38.25 hours/week. The municipality has initiated, decided and will implement the changes and the researchers are asked to follow the project.

Nurses from the municipality implementing reduced working hours and nurses from municipalities without changed working hours will be invited to participate in the study. The nurses will answer a questionnaire before and after the changes (6 and 12 months after the first data collection).

The overall aim of the research is to investigate registered nurses' experiences of their work environment, health, well-being and intention to quit/remain, as well as the quality of care, nurse turnover and sick leave. To study the relationship between shortening working hours or not, nurses' assessments of the work environment, intention to quit/remain, health, well-being and quality of care.

The main research questions are:

* What are the relationships over time between working hours reduction or not, sociodemographic factors, nurse-rated work environment, intention to quit/remain, health, well-being and nurse-rated quality of care (follow-up after 12 months)? * What changes occur over time in nurses' assessments of work environment, intention to quit/remain, health, well-being and quality of care, and are there any differences compared to a comparison group/municipalities?

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Key information

Conditions

Sex eligibility

All sexes

Study type

Observational

Primary location

University of Gävle

Gävle, 80176, Sweden

Location contact

Maria Engström, PhD Professor

CONTACT

[email protected]

+4626648215

Maria Engström, PhD Professor

PRINCIPAL_INVESTIGATOR

About this study

The research project has a prospective design and all nurses (approximately 40) in the municipality where the working hours reduction is implemented will be asked to participate, as well as all nurses in five comparison municipalities (approximately 150).

Data analysis: For the correlation analyses, bivariate correlation analyses and regression analyses (univariate and multiple) or Generalized Estimating Equations (GEE) will be used. GEE to take clustering into account. For the comparative tests, t-test or ANOVA/ANCOVA will be used or equivalent non-parametric tests if the data is not normally distributed.

To study relationships in a multiple linear regression analysis, 50+8*m (people) are required, where m is the number of variables included in the relationship analysis. In this case, investigators expect to use approximately 5-10 explanatory variables, one of which is working time reduction or not, i.e. approximately 90-130 participants. Investigators will invite approximately 190 nurses and expect that some nurses will decline or drop out over time.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Registered nurses working in elderly care or in municipal home care.

Exclusion criteria

  • Registered nurses on long-term leave.

Treatment and study plan

Shortened working hours

Other

In one of the municipalities in this research project, they will introduce shortened working hours for registered nurses. A shortened working hours (reduced full-time standard by 3.25 hours/week with maintained salary) during a one-year pilot project for nurses in elderly care and municipal home care. Current full-time standard 38.25 hours/week. The municipality has initiated, decided and will implement the changes and the researchers are asked to follow the project.

Primary outcomes

  1. Well-being - Work-life balance - dimension "work interference with personal life"

    Time frame: Data collection before the changes (pre-), and then 6 and 12 months after the first data collection (post data collection). For the 6-months data collection only nurses in the group with shortened working hours, at 12 months all nurses.

    A scale will be used for nurses' self-rated work-life balance - "the 17-item work/non-work interference and enhancement scale", response options 5-grade 1) not at all to 5) almost always. Four dimensions: work interference with personal life, personal life interference with work, work enhancement of personal-life, and personal life enhancement of work. For this outcome, it is the dimension "work interference with personal life" and higher scores represent imbalance/an undesirable outcome.

  2. Well-being - Work-life balance - dimension "work enhancement of personal life"

    Time frame: Data collection before the changes (pre-), and thereafter 6 and 12 months after the first data collection (post data collection). For the 6-months data collection only nurses in the group with shortened working hours, at 12 months all nurses.

    A scale will be used for nurses' self-rated work-life balance - "the 17-item work/nonwork interference and enhancement scale", response options 5-grade 1) not at all to 5) almost always. Four dimensions: work interference with personal life, personal life interference with work, work enhancement of personal life, and personal life enhancement of work. For this outcome, it is the dimension "work enhancement of personal life" and higher scores represent balance/a desirable outcome.

Secondary outcomes

  1. Well-being - Work-life balance - dimension "personal life enhancement of work"

    Time frame: Data collection before the changes (pre-), and thereafter 6 and 12 months after the first data collection (post data collection). For the 6-months data collection only nurses in the group with shortened working hours, at 12 months all nurses.

    A scale will be used for nurses' self-rated work-life balance - "the 17-item work/nonwork interference and enhancement scale", response options 5-grade 1) not at all to 5) almost always. Four dimensions: work interference with personal life, personal life interference with work, work enhancement of personal life, and personal life enhancement of work. For this outcome, it is the dimension "personal life enhancement of work" and higher scores represent balance/a desirable outcome.

  2. Well-being - Recovery experience

    Time frame: Data collection before the changes (pre-), and thereafter 12 months after the first data collection (post data collection).

    The Recovery Experience Questionnaire will be used , response options 5-grade Likert-scale, item scores are averaged and higher scores represent a better recovery experience.

  3. Well-being - Thriving

    Time frame: Data collection before the changes (pre-), and thereafter 12 months after the first data collection (post data collection).

    The 10-item Thriving scale will be used to measure thriving, 5-point response alternatives. For total score the mean is calculated and a higher score represent higher thriving.

  4. Well-being - Intention to quite/leave the job

    Time frame: Data collection before the changes (pre-), and thereafter 12 months after the first data collection (post data collection).

    One question on intention to leave from the Satisfaction with work questionnaires, 'Have you recently seriously considered quitting your job on the unit because you don't enjoy it?', with response alternatives 1) No, 2) Yes, but I have not done anything and 3) Yes, and I have taken action.

  5. Well-being - Intention to remain at this workplace

    Time frame: Data collection before the changes (pre-), and thereafter 12 months after the first data collection (post data collection).

    1 study specific question "Is it your intention to stay at this workplace?" Response options (…) yes (…) no

  6. Well-being - Job satisfaction

    Time frame: Data collection before the changes (pre-), and thereafter 6 and 12 months after the first data collection (post data collection). For the 6-months data collection only nurses in the group with shortened working hours, at 12 months all nurses.

    The 4-item Brief index of affective job satisfaction will be used, response options 1 = Strongly disagree, 2 = Disagree, 3 = Neutral, 4 = Agree, 5 = Strongly agree. Items are averaged to get the total score and higher scores represent higher job satisfaction

  7. Well-being - Life satisfaction

    Time frame: Data collection before the changes (pre-), and thereafter 6 and 12 months after the first data collection (post data collection). For the 6-months data collection only nurses in the group with shortened working hours, at 12 months all nurses.

    1 item from the Life satisfaction questionnaire will be used, 7-grade response alternatives (1. Very low to 7. Very high) and higher scores representing better life satisfaction.

  8. Health - Stress symptoms

    Time frame: Data collection before the changes (pre-) and 12 months after the first data collection (post data collection). After 6 months, nurses from the municipality with reduced working hours will answer 1 question about tiredness from the stress scale.

    Stress symptoms will be measured using the Psychosomatic health aspects scale, one factor 10 items. Response alternatives are 5-grade [1) very often, 2) Quite often 3) Sometimes 4) Seldom 5) Never]. Scores from the ten items are averaged for factor score, and higher scores represent more stress symptoms.

  9. Health - Sleep quality

    Time frame: Data collection before the changes (pre-), and thereafter 6 and 12 months after the first data collection (post data collection). For the 6-months data collection only nurses in the group with shortened working hours, at 12 months all nurses.

    1 question about sleep quality from the Satisfaction with work questionnaires: "Overall, how do you rate your sleep quality?" 5-grade response alternatives from 1) Very bad to 5) Very god

  10. Health - Depression symptoms

    Time frame: Data collection before the changes (pre-), and 12 months after the first data collection (post data collection).

    The Patient health questionnaire-2 will be used that gives a score for depression 0-6, higher score more depressive symptoms, each item rated from 0 "not at all" to 3 "nearly every day".

  11. Health - Anxiety symptoms

    Time frame: Data collection before the changes (pre-), and 12 months after the first data collection (post data collection).

    The Generalized anxiety disorder scale -2 will be used that gives a score for anxiety 0-6, higher score more anxiety symptoms, each item rated from 0 "not at all" to 3 "nearly every day".

  12. Health - Burnout

    Time frame: Data collection before the changes (pre-), and 12 months after the first data collection (post data collection).

    The factor burnout from the Copenhagen psychosocial questionnaire III will be used, four items that are averaged, response alternatives on a 5-point scale from 1. All the time to 5. Not at all. Higher scores representing a better outcome.

  13. Work environment - Work situation

    Time frame: Data collection before the changes (pre-), and thereafter 6 and 12 months after the first data collection (post data collection). For the 6-months data collection only nurses in the group with shortened working hours, at 12 months all nurses.

    1 item from the Life satisfaction questionnaire will be used, 7-grade response alternatives from 1. Very unhappy to 7. Very happy and higher scores representing a better work situation "How do you like your work situation?"

  14. Work environment - Structural conditions/empowerment

    Time frame: Data collection before the changes (pre-), and thereafter 12 months after the first data collection (post data collection).

    To measure structural conditions/empowerment the 19-item Condition of work effectiveness scale-II will be used. The total score for the scale range from 6 to 30, higher scores representing better structural conditions. Response alternatives for each item are 5-grade (1. None to 5. A lot).

  15. Work environment - Quantitative demands

    Time frame: Data collection before the changes (pre-), and 12 months after the first data collection (post data collection).

    The factor quantitative demands from the Copenhagen psychosocial questionnaire III will be used, three items that are averaged, response alternatives on a 5-point scale from 1. Always to 5. Never/Almost never. Higher scores mean a better outcome.

  16. Work environment - Emotional demands

    Time frame: Data collection before the changes (pre-), and 12 months after the first data collection (post data collection).

    The factor emotional demands from the Copenhagen psychosocial questionnaire III will be used, three items that are averaged with response alternatives on a 5-point scale from 1. Always to 5. Never/Almost never. Higher scores mean a better outcome.

  17. Work environment - Work pace

    Time frame: Data collection before the changes (pre-), and 12 months after the first data collection (post data collection).

    The factor work pace from the Copenhagen psychosocial questionnaire III will be used, two items that are averaged, response alternatives on a 5-point scale from 1. Always to 5. Never/Almost never. Higher scores mean a better outcome.

  18. Work environment - Social support from colleagues

    Time frame: Data collection before the changes (pre-), and thereafter 6 and 12 months after the first data collection (post data collection). For the 6-months data collection only nurses in the group with shortened working hours, at 12 months all nurses.

    The factor social support from colleagues from the Copenhagen psychosocial questionnaire III will be used, two items that are averaged, response alternatives on a 5-point scale from 1. Always to 5. Never/Almost never. Higher scores mean a worse outcome.

  19. Work environment - Social community at work

    Time frame: Data collection before the changes (pre-) and 12 months after the first data collection (post data collection).

    The factor social community at work from the Copenhagen psychosocial questionnaire III will be used, three items that are averaged, response alternatives on a 5-point scale from 1. Always to 5. Never/Almost never. Higher scores mean a worse outcome.

  20. Work environment - Commitment to the organization

    Time frame: Data collection before the changes (pre-), and thereafter 6 and 12 months after the first data collection (post data collection). For the 6-months data collection only nurses in the group with shortened working hours, at 12 months all nurses.

    The factor commitment to the organization from the Copenhagen Psychosocial Questionnaire III will be used, three items that are averaged, response alternatives on a 5-point scale. Higher scores mean a worse outcome.

  21. Quality of care - Nurse satisfaction with given care

    Time frame: Data collection before the changes (pre-), and thereafter 12 months after the first data collection (post data collection).

    The Nurse Satisfaction with Given Care Scale will be used. Response alternatives are 7-grade Likert scale (1. Not at all to 7. To a very high extent). For total score, the item scores are averaged, with higher scores representing greater satisfaction.

  22. Well-being - Stress, work-life balance and recovery

    Time frame: Data collection before the changes (pre-), and thereafter 6 and 12 months after the first data collection (post data collection). For the 6-months data collection only nurses in the group with shortened working hours, at 12 months all nurses.

    An index of three study specific items with 7-grade response options from 1) not true at all to 7) completely true, higher scores representing less stress, better balance and recovery

  23. Quality of care - Productivity and efficient work

    Time frame: Data collection before the changes (pre-), and thereafter 6 and 12 months after the first data collection (post data collection). For the 6-months data collection only nurses in the group with shortened working hours, at 12 months all nurses.

    An index of 2 study-specific items with 7-grade response options from 1) not true at all to 7) completely true, higher scores better productivity

  24. Health - sick days

    Time frame: Data collection before the changes (pre-), and thereafter 6 and 12 months after the first data collection (post data collection). For the 6-months data collection only nurses in the group with shortened working hours, at 12 months all nurses.

    In the survey, a question about the number of sick days - open-ended response option where the number of sick days is stated.

Other outcomes

  1. Well-being - Work-life balance - dimension "personal life interference with work"

    Time frame: Data collection before the changes (pre-), and thereafter 6 and 12 months after the first data collection (post data collection). For the 6-months data collection only nurses in the group with shortened working hours, at 12 months all nurses.

    A scale will be used for nurses' self-rated work-life balance - "the 17-item work/nonwork interference and enhancement scale", response options 5-grade 1) not at all to 5) almost always. Four dimensions: work interference with personal life, personal life interference with work, work enhancement of personal life, and personal life enhancement of work. For this outcome, it is the dimension "personal life interference with work" and higher scores represent imbalance/an undesirable outcome.

  2. Work environment - Influence/impact in work

    Time frame: Data collection before the changes (pre-) and 12 months after the first data collection (post data collection).

    Two questions about the possibility of influence/impact in work from the Satisfaction with work questionnaires, 5-grade reseponse options for each item, scores are averaged and higher scores represent more influence/impact

Study contacts

Contact information is provided by the study sponsor or research team.

Charlotte Roos, PhD

CONTACT

[email protected]

Maria Engström, Professor, PhD

CONTACT

[email protected]

+4626648215

Sponsors and collaborators

Lead sponsor

University of Gavle

Other

Registry information

Official study title

Shortened Working Hours for Registered Nurses in Elderly Care and Municipal Home Care - How is it Linked to Nurse-rated Work Environment, Work-life Balance and Well-being?

Important dates

Study start
2026
Primary completion
2027
Study completion
2027
First posted
Apr 9, 2026
Registry last updated
Apr 28, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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