Mental Workload as Predictor of Work-Related Quality of Life in Healthcare Workers

Abstract

Aim: The aim of this study was to examine the association between mental workload and work-related quality of life among healthcare workers. Methods: This cross-sectional study included healthcare professionals across Türkiye, and data were collected using an online survey between April and June 2025. The questionnaire included a demographic information section and scales assessing mental workload and work-related quality of life. The study sample consisted of 417 healthcare workers. The relationships between variables were examined using correlation and hierarchical multiple regression analyses. Results: The regression analysis was conducted using three models. In the first model, only demographic variables were included; in the second model, demographic variables were combined with occupational variables; and in the final model, the mental workload scale was included alongside all other variables to assess the determinants of work-related quality of life. In the third model, the total explained variance increased compared to the previous models. Conclusion: The results indicate that the demographic and occupational variables of healthcare workers generally do not determine their work-related quality of life, whereas mental workload is a significant negative determinant of work-related quality of life.

Keywords

• Healthcare Workers
• Mental Workload
• Work-Related Quality of Life

Sağlık Çalışanlarında İş Yaşam Kalitesinin Belirleyicisi Olarak Zihinsel İş Yükü

Abstract

Amaç: Bu çalışmanın amacı, sağlık çalışanlarının zihinsel iş yükü düzeyleri ile iş yaşam kalitesi arasındaki ilişkiyi belirlemektir. Yöntem: Kesitsel tasarımla yürütülen bu çalışma, Türkiye genelindeki sağlık profesyonellerini kapsamaktadır. Veriler Nisan-Haziran 2025 tarihleri arasında çevrimiçi anket yöntemi ile toplanmıştır. Anket, demografik bilgileri içeren bölüm ile zihinsel iş yükü ve iş yaşam kalitesi ölçeklerinden oluşmaktadır. Çalışma örneklemi 417 sağlık çalışanından oluşmaktadır. Değişkenler arasındaki ilişkiler, korelasyon ve hiyerarşik çoklu regresyon analizleri ile incelenmiştir. Bulgular: Regresyon analizi üç model üzerinden gerçekleştirilmiştir. Birinci modelde yalnızca demografik değişkenler yer almıştır; ikinci modelde demografik değişkenlere mesleki değişkenler eklenmiştir; üçüncü ve son modelde ise zihinsel iş yükü ölçeği diğer tüm değişkenlerle birlikte iş yaşam kalitesinin belirleyicilerini değerlendirmek için dahil edilmiştir. Üçüncü modelde toplam açıklanan varyans, önceki modellere kıyasla artış göstermiştir. Sonuç: Bulgular, sağlık çalışanlarının demografik ve mesleki değişkenlerinin genel olarak iş yaşam kalitesini belirlemediğini, buna karşın zihinsel iş yükünün iş yaşam kalitesinin anlamlı ve negatif yönlü belirleyicisi olduğunu göstermektedir.

Keywords

• Sağlık Çalışanları
• Zihinsel İş Yükü
• İş Yaşam Kalitesi

References

1. Abe, E. N., Fields, Z., & Abe, I. I. (2016). The efficacy of wellness programmes as work-life balance strategies in the South African public service. Journal of Economics and Behavioural Studies, 8(6), 52-67. https://doi.org/10.22610/jebs.v8i6(J).1483
2. Akar, H., & Üstüner, M. (2017). Turkish adaptation of work-related quality of life scale: Validity and reliability studies. İnönü University Journal of the Faculty of Education, 18(2), 159-176. https://doi.org/10.17679/inuefd.302675
3. Akca, M., Yavuz, M., & Küçükoğlu, M. T. (2020). Measurement of mental workload: Turkish adaptation of CarMen-Q questionnaire. Journal of Yasar University, 15(60), 675-691. https://doi.org/10.19168/jyasar.708357
4. Altay, G., Pehlivan, Z., & Yavuz, A. Y. (2022). Determining the relationship between nurses' perceived social support levels and quality of life during the pandemic process. Gümüşhane University Journal of Health Sciences, 11(4), 1443-1451. https://doi.org/10.37989/gumussagbil.1135905
5. Asante, J. O., Li, M. J., Liao, J., Huang, Y. X., & Hao, Y. T. (2019). The relationship between psychosocial risk factors, burnout and quality of life among primary healthcare workers in rural Guangdong province: a cross-sectional study. BMC Health Services Research, 19(1), 447. https://doi.org/10.1186/s12913-019-4278-8
6. Borghini, G., Astolfi, L., Vecchiato, G., Mattia, D., & Babiloni, F. (2014). Measuring neurophysiological signals in aircraft pilots and car drivers for the assessment of mental workload, fatigue and drowsiness. Neuroscience and Biobehavioral Reviews, 44, 58-75. https://doi.org/10.1016/j.neubiorev.2012.10.003
7. Bradley, J. R., & Cartwright, S. (2002). Social support, job stress, health, and job satisfaction among nurses in the United Kingdom. International Journal of Stress Management, 9(3), 163-182. https://doi.org/10.1023/A:1015567731248
8. Cohen, J. (2013). Statistical power analysis for the behavioral sciences. routledge. Congdon, J., Craft, J., & Christensen, M. (2020). Are we measuring nursing workflow correctly? A literature review. British Journal of Nursing, 29(21), 1252-1259. https://doi.org/10.12968/bjon.2020.29.21.1252

9. Dehghan Nayeri, N., Salehi, T., & Ali Asadi Noghabi, A. (2011). Quality of work life and productivity among Iranian nurses. Contemporary Nurse, 39(1), 106-118. https://doi.org/10.5172/conu.2011.39.1.106
10. Emeç, Ş., & Akkaya, G. (2018). Evaluation of mental work on the health sector and an application. Ergonomics, 1(3), 156-162. https://doi.org/10.33439/ergonomi.470474
11. Esfahani, E. N., Farhadi, S., Esmaeili, R., Esmaeili, S. V., Niroumand, M., & Jalali, M. (2025). Subjective mental workload profile and its relationship with quality of work life among nurses: The mediating role of general health. Work, 82(1), 231-240. https://doi.org/10.1177/10519815251339436
12. Fikri, Z., Bellarifanda, A., Sunardi, S., Rosyidul'Ibad, M., & Mu'jizah, K. (2024). The relationship between mental workload and nurse stress levels in hospitals. Healthcare in Low-resource Settings, 12(1). https://doi.org/10.4081/hls.2023.11817
13. Fradelos, E., Mpelegrinos, S., Mparo, C., Vassilopoulou, C., Argyrou, P., Tsironi, M., ... & Theofilou, P. (2014). Burnout syndrome impacts on quality of life in nursing professionals: The contribution of perceived social support. Progress in Health Sciences, 4(1), 102-109. https://doi.org/10.4081/hpr.2014.984
14. Galy, E., Cariou, M., & Mélan, C. (2012). What is the relationship between mental workload factors and cognitive load types?. International Journal of Psychophysiology, 83(3), 269-275. https://doi.org/10.1016/j.ijpsycho.2011.09.023
15. George, D., & Mallery, P. (2024). IBM SPSS statistics 29 step by step: A simple guide and reference. routledge. https://doi.org/10.4324/9781032622156
16. Güçlü, A., & Kurşun, Ş. (2018). Quality of work life and related factors of nurses working in surgical clinics. Florence Nightingale Journal of Nursing, 26(3), 187-197. https://doi.org/10.26650/FNJN285947
17. Hertzum, M., & Holmegaard, K. D. (2013). Perceived time as a measure of mental workload: Effects of time constraints and task success. International Journal of Human-Computer Interaction, 29(1), 26-39. https://doi.org/10.1080/10447318.2012.676538
18. Horrigan, J. M., Lightfoot, N. E., Larivière, M. A., & Jacklin, K. (2013). Evaluating and improving nurses' health and quality of work life: A cross-sectional study of Korean blue collar workers employed by small businesses. Workplace Health and Safety, 61(4), 173-181. https://doi.org/10.1177/216507991306100405
19. Huhtala, M., Geurts, S., Mauno, S., & Feldt, T. (2021). Intensified job demands in healthcare and their consequences for employee well‐being and patient satisfaction: A multilevel approach. Journal of Advanced Nursing, 77(9), 3718-3732. https://doi.org/10.1111/jan.14861
20. Kaçmaz, D., & Çiçek, H. (2024). The effect of mental workload on work life quality and psychological resilience in organizations. 19 Mayıs Journal of Social Sciences, 5(1), 48-60. https://doi.org/10.52835/19maysbd.1390866 Karaca, B. R., & Oğuzhan, G. (2023). The relationship between mental workload and burnout: Example of health personnel. BANU Journal of Health Science and Research, 5(2), 100-109. https://doi.org/10.46413/boneyusbad.1161161 Karadağ, M., & Cankul, İ. (2015). The evaluation of mental workload in nurses. Journal of Anatolia Nursing and Health Sciences, 18(1), 26-34. https://doi.org/10.17049/ahsbd.46804
21. Kaur, H., & Malhotra, N. (2018). General mental health issues in relation with job satisfaction among nurses. Indian Journal of Community Psychology, 14(1).
22. Kesti, R., Kanste, O., Konttila, J., & Oikarinen, A. (2023). Quality of working life of employees in public healthcare organization in Finland: A cross‐sectional study. Nursing Open, 10(9), 6455-6464. https://doi.org/10.1002/nop2.1896
23. Kılıç, R., & Keklik, B. (2012). A study about health care workers on the effect of the quality of work life and the motivation. Afyon Kocatepe University Journal of Economics and Administrative Sciences, 14(2), 147-160.
24. Koca, M., Deniz, S., İnceoğlu, F., & Kılıç, A. (2024). The Effects of Workload Excess on Quality of Work Life in Third-Level Healthcare Workers: A Structural Equation Modeling Perspective. Healthcare (Basel, Switzerland), 12(6), 651. https://doi.org/10.3390/healthcare12060651
25. Koozekonan, A. G., Moshiran, V. A., Yarandi, M. S., Golmohammapour, H., Sarbaz, B., & Zakerian, S. A. (2021). Study of the relationship between physical and mental workload with quality of work life of workers in the foundry industry. J Health Saf Work, 11(3), 488-502.
26. Maqsood, M. B., Islam, M. A., Naqvi, A. A., Al Qarni, A., Al-Karasneh, A. F., Iffat, W., ... & Haseeb, A. (2021). Assessment of quality of work life (QWL) among healthcare staff of intensive care unit (ICU) and emergency unit during COVID-19 outbreak using WHOQoL-BREF. Saudi Pharmaceutical Journal, 29(11), 1348-1354. https://doi.org/10.1016/j.jsps.2021.09.002
27. Nair, G. S. (2013). A study on the effect of quality of work life (QWL) on organisational citizenship behaviour (OCB)-with special reference to college teachers is thrissur district, kerala. Integral Review, 6(1), 34-46.
28. Nikeghbal, K., Kouhnavard, B., Shabani, A., & Zamanian, Z. (2021). Covid-19 effects on the mental workload and quality of work life in Iranian nurses. Annals of Global Health, 87(1), 79. https://doi.org/10.5334/aogh.3386
29. Öksüz, E., Demiralp, M., Mersin, S., Tüzer, H., Aksu, M., & Sarıkoc, G. (2019). Resilience in nurses in terms of perceived social support, job satisfaction and certain variables. Journal of Nursing Management, 27(2), 423-432. https://doi.org/10.1111/jonm.12703
30. Özkılıçcı, G., & Aytaç, S. (2022). An investigation of the relationships between mental workload, job satisfaction, wage satisfaction, and intention to leave the job. International Journal of Social Inquiry, 15(2), 277-293. https://doi.org/10.37093/ijsi.1125305
31. Parveen, M., Maimani, K., & Kassim, N. M. (2017). Quality of work life: The determinants of job satisfaction and job retention among RNs and OHPs. International Journal for Quality Research, 11(1), 173.
32. Rostami, F., Babaei-Pouya, A., Teimori-Boghsani, G., Jahangirimehr, A., Mehri, Z., & Feiz-Arefi, M. (2021). Mental workload and job satisfaction in healthcare workers: The moderating role of job control. Frontiers in Public Health, 9, 683388. https://doi.org/10.3389/fpubh.2021.683388
33. Rubio-Valdehita, S., López-Núñez, M. I., López-Higes, R., & Díaz-Ramiro, E. M. (2017). Development of the CarMen-Q Questionnaire for mental workload assessment. Psicothema, 29(4), 570-576. https://doi.org/10.7334/psicothema2017.151
34. Ruiz-Fernández, M. D., Ramos-Pichardo, J. D., Ibañez-Masero, O., Sánchez-Ruiz, M. J., Fernández-Leyva, A., & Ortega-Galán, Á. M. (2021). Perceived health, perceived social support and professional quality of life in hospital emergency nurses. International Emergency Nursing, 59, 101079. https://doi.org/10.1016/j.ienj.2021.101079
35. Saedpanah, K., Ghasemi, M., Akbari, H., Adibzadeh, A., & Akbari, H. (2022). Effects of workload and job stress on the shift work disorders among nurses: PLS SEM modeling. European Journal of Translational Myology, 33(1), 10909. https://doi.org/10.4081/ejtm.2022.10909
36. Saraji, G. N., & Dargahi, H. (2006). Study of quality of work life (QWL). Iranian Journal of Public Health, 35(4), 8-14.
37. Sevinik, H., & Lök, N. (2022). Determination of relationship between mental workload and work performance in nurses. Göbeklitepe Medical Science Journal, 5(8), 37-44.
38. Shojaei, F., Puryaghoob, M., Babahaji, M., Rezaei, S. G., & Jafari, S. (2019). The relationship between quality of life and social support among nurses: A cross-sectional study. Industrial Psychiatry Journal, 28(2), 242-247. https://doi.org/10.4103/ipj.ipj_29_20
39. Singh, S., & Chaudhary, N. (2019). Quality of work life and dynamics of work-related wellbeing: an exploratory study of textile employees. International Management Review, 15(2), 77-84.
40. Sirgy, M. J., Efraty, D., Siegel, P., & Lee, D. J. (2001). A new measure of quality of work life (QWL) based on need satisfaction and spillover theories. Social Indicators Research, 55(3), 241-302. https://doi.org/10.1023/A:1010986923468
41. Sunman, G. (2025). The mediating role of job satisfaction in the effect of mental workload on career satisfaction. Nevşehir Hacı Bektaş Veli University Journal of ISS, 15(1), 181-202. https://doi.org/10.30783/nevsosbilen.1615932
42. Swamy, D. R., Nanjundeswaraswamy, T. S., & Rashmi, S. (2015). Quality of work life: Scale development and validation. International Journal of Caring Sciences, 8(2), 281.
43. Tabachnick, B. G., & Fidell, L. S. (2013). Using multivariate statistics (6th ed.). Boston, MA: Pearson.
44. Tanrıverdi, D., & Özgüç, S. (2026). The effect on quality of working life of psychological resilience levels of firefighters. Work, 83(2), 551-559. https://doi.org/10.1177/10519815251377960
45. Tosun, S., & Yılmaz, İ. (2023). Measuring the mental workload of specialists and practitioners with the CarMen-Q method and evaluating the differences. Ergonomics, 6(2), 132-144. https://doi.org/10.33439/ergonomi.1272038
46. Van Acker, B. B., Parmentier, D. D., Vlerick, P., & Saldien, J. (2018). Understanding mental workload: from a clarifying concept analysis toward an implementable framework. Cognition, Technology and Work, 20(3), 351-365. https://doi.org/10.1007/s10111-018-0481-3
47. Van Laar, D., Edwards, J. A., & Easton, S. (2007). The work‐related quality of life scale for healthcare workers. Journal of Advanced Nursing, 60(3), 325-333. https://doi.org/10.1111/j.1365-2648.2007.04409.x
48. Yadav, R., & Khanna, A. (2014). Literature review on quality of work life and their dimensions. IOSR Journal of Humanities and Social Science, 19(9), 71-80. https://doi.org/10.9790/0837-19957180
49. Yıldırım, A., & Hacıhasanoğlu, R. (2011). Quality of life and effective variables among health care professionals. Journal of Psychiatric Nursing, 2(2), 61-68.
50. Young, M. S., Brookhuis, K. A., Wickens, C. D., & Hancock, P. A. (2015). State of science: mental workload in ergonomics. Ergonomics, 58(1), 1-17. https://doi.org/10.1080/00140139.2014.956151
51. Younis, J., Wang, L., Abed, A., Jiang, H., Fan, Y., Li, Z., ... & Zhang, W. (2025). Quality of life among healthcare workers in the hospitals and primary healthcare centers in Gaza Strip: A cross-sectional study. BMC Psychology, 13(1), 69. https://doi.org/10.1186/s40359-025-02386-9
52. Yousef, C. C., Farooq, A., Amateau, G., Abu Esba, L. C., Burnett, K., & Alyas, O. A. (2024). The effect of job and personal demands and resources on healthcare workers’ wellbeing: A cross-sectional study. Plos One, 19(5), e0303769. https://doi.org/10.1371/journal.pone.0303769
53. Yuan, Z., Wang, J., Feng, F., Jin, M., Xie, W., He, H., & Teng, M. (2023). The levels and related factors of mental workload among nurses: A systematic review and meta‐analysis. International Journal of Nursing Practice, 29(5), e13148. https://doi.org/10.1111/ijn.13148j