The impact of role stress and work-family balance on nurses' professional quality of life: a network analysis.

Objective: To explore the network structure linking role stress, work-family balance, and professional quality of life among nurses, and to identify key nodes that may be particularly relevant for future intervention research. Methods: A cross-sectional survey was conducted with 1,879 nurses from four tertiary hospitals in China. Measures included the Professional Quality of Life Scale, Role Stressors Scale, and Work-Family Balance Scale. A Gaussian Graphical Model with LASSO regularization was estimated to visualize the conditional dependence structure. Strength centrality and bridge strength were computed to identify influential nodes, and stability was assessed via bootstrap procedures. Results: The network comprised 10 nodes and 39 nonzero edges (86.7% density) across three clusters: professional quality of life, role stress, and work-family balance. The strongest edge within the professional quality of life cluster was between "A1 Compassion Satisfaction" and "A2 Burnout" (weight = 0.64). The strongest cross-cluster edge connected "B3 Role Overload" and "C1 Work-to-Family Conflict" (weight = 0.37). "A3 Secondary Traumatic Stress" showed the highest strength centrality and the highest bridge strength, followed by "C1 Work-to-Family Conflict." Bootstrap procedures confirmed excellent stability for both strength and bridge strength centrality (CS-coefficients >0.75). Conclusion: Secondary traumatic stress and work-to-family conflict occupy structurally central and bridging positions in the network linking professional quality of life, role stress, and work-family balance. Their high centrality and bridge strength underscore their potential relevance as targets for future intervention research, although the cross-sectional design precludes causal inference.