Journal of Nursing Management, 2016

Work–family conflict and enrichment in nurses: between
job demands, perceived organisational support and
work–family backlash
CHIARA GHISLIERI P h D 1, PAOLA GATTI
CLAUDIO G. CORTESE P h D 4

PhD

2,3

, MONICA MOLINO

PhD

2

and

1

Associate Professor of Work and Organizational Psychology, 2Research Fellow, 4Full Professor of Work and
Organizational Psychology, Department of Psychology, University of Turin, Italy and 3Durham University
Business School, University of Durham, UK

Correspondence
Claudio Giovanni Cortese
Dipartimento di Psicologia
Universita degli Studi di Torino
Via Verdi 10
10124 Torino
Italy
E-mail: claudio.cortese@unito.it

GHISLIERI C., GATTI

P., MOLINO M. & CORTESE C.G. (2016) Journal of Nursing
Management
Work–family conflict and enrichment in nurses: between job demands,
perceived organisational support and work–family backlash

Aim This study investigated how work relationships (perceived organisational
support, supervisor and co-worker work–family backlash) and job demands
(workload, emotional dissonance) can interact with work–family conflict and
work–family enrichment.
Background Despite the extensive literature on the work–family interface, few
studies on the nursing profession have considered the role of job demands and
work relationships, focusing on both the positive and negative side of the work–
family interface.
Method The study involved a sample of 500 nurses working in an Italian
hospital. Hierarchical multiple regression analyses were used to test hypotheses.
Results Analyses showed that work–family conflict has a positive relationship
with job demands and supervisor backlash, and a negative relationship with
perceived organisational support. Work–family enrichment was found to have a
negative relationship with job demands and a positive relationship with perceived
organisational support. No significant relationships were found between work–
family enrichment and both backlash dimensions.
Conclusion The study confirmed the importance of promoting a balance between
job demands and resources in order to create favourable conditions for work–
family enrichment and to prevent work–family conflict.
Implications for nursing management The findings suggest that it may be
advisable for health-care organisations to invest in measures at individual, team
and organisational levels, specifically in training and counselling for nurses and
supervisors.
Keywords: job demands, nurses, perceived organisational support, work–family
backlash, work–family conflict, work–family enrichment
Accepted for publication: 20 September 2016

DOI: 10.1111/jonm.12442
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1

C. Ghislieri et al.

Introduction
The number of studies on the work–family interface
has increased over the past decades, following changes
in demographics (more dual-earner or dual-career couples and single-parent families) and working conditions (more job insecurity and more blurring of
boundaries between work and life; Ghislieri &
Colombo 2014). As a result of these changes, workers
are less able to handle tasks and demands from both
work and family domains effectively. The issues of
work–family conflict (WFC) and work–family enrichment (WFE) are central to understanding work
dynamics in organisations and the relation among
work and other life fields. This is especially true for
the nursing profession (Cortese et al. 2010, Ghislieri
et al. 2011), where scholars have suggested that WFC
is related to lower work satisfaction and higher turnover intentions, as well as burnout and health impairment (Grzywacz et al. 2006, van der Heijden et al.
2008, Cortese et al. 2010), while WFE is related to
higher levels of professional commitment and lower
intentions to leave the profession (Russo & Buonocore
2012, Tummers & Den Dulk 2013, Ghislieri et al.
2015).
The study used a sample of Italian nurses to explore
how certain job demands and specific kinds of work
relationships can interact with WFC and WFE. A
number of studies highlighted how job demands,
specifically workload and emotional dissonance (Bakker & Heuven 2006), were among the main determinants of WFC in the various contexts where the
relationship with others was central (Cortese et al.
2010, Ghislieri et al. 2012). The relation between job
demands and WFE has been less investigated in the literature since enrichment is mainly linked to resources,
even though recent studies have shown the relevance
of a certain level of job demands in fostering work
engagement and activation on the job (Bakker et al.
2010).
Concerning work relationships, this study focused
on two aspects that have rarely been investigated, to
date. Only a few investigations have considered general perceived organisational support (POS), emphasising the ‘antidote effect’ of the negative consequences
of WFC (Casper et al. 2002) and hypothesising that
organisational support provides a feeling that socioemotional needs are fulfilled, which in turn ‘allows
people to derive benefits from work and apply them
to family life (i.e. WFE)’ (McNall et al. 2011, p. 137).
McNall et al. (2011) confirmed the strong positive
relationship between POS and WFE.
2

Another topic considered in the literature but less
investigated in empirical research is work–family
backlash (Young 1999), defined as the resentment that
workers feel from supervisors and co-workers towards
their efforts to balance work and family life (Korabik
& Warner 2009, Colombo & Ghislieri 2014). Few
studies have investigated backlash and its relation to
work–family balance perceptions (Ricotta et al. 2011).
To summarise, the objective of this study was to
investigate the relationships between two job demands
(workload and emotional dissonance) and three work
relationships (POS, supervisor backlash and co-worker
backlash) as antecedents, and WFC and WFE as outcome variables.

Theoretical background
WFC and enrichment in nurses
The work–family interface is defined as the process in
which an individual’s functioning in the work (or family) domain is influenced by pressures and resources
from the family (or work) domain (Bakker et al.
2011). Among the theoretical models, which address
the work–family interface, the conflict perspective
dominated for most of the 1980s and 1990s, while the
enrichment perspective has become increasingly
important in the past two decades (Ghislieri et al.
2011, Russo & Buonocore 2012).
The WFC model originates from role theory (Merton 1957) and from Goode’s (1960) role strain
hypothesis. Work–family conflict has been defined as
‘a form of inter-role conflict in which the role pressures from the work and family domains are mutually
incompatible in some respect. That is, participation in
the work (family) role is made more difficult by virtue
of participation in the family (work) role’ (Greenhaus
& Beutell 1985, p. 77). Work–family conflict may be
due to time issues, but may also derive from different
kinds of stressors or from incompatible behavioural
demands.
Recently, scholars have focused their attention on
the link between WFC and WFE. Enrichment is a process whereby one role enhances the quality of the
other: ‘work-to-family enrichment occurs when work
experiences improve the quality of family life, and
family-to-work enrichment (FWE) occurs when family
experiences improve the quality of work life’ (Greenhaus & Powell 2006, p. 73). Two mechanisms
describe the enrichment process: the ‘instrumental’
mechanism occurs when resources are shifted from
one role to the other, with a direct instrumental effect
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Journal of Nursing Management

Work–family conflict and enrichment

that enhances functioning in the second role; the
‘affective’ mechanism occurs when extensive resources
from one role increase the positive affect within this
role that, in turn, fosters the functioning in the other
one (Greenhaus & Powell 2006).
Recently, research has indicated that WFE should be
considered as important for both employees and
organisations (Molino et al. 2013). Existing research
shows that WFE is positively associated with jobrelated (Boyar & Mosley 2007, Shockley & Singla
2011), family-related (van Steenbergen et al. 2007)
and health-related outcomes (van Steenbergen & Ellemers 2009). Moreover, scholars have found that some
personality traits, including extraversion and positive
affectivity, can influence WFE (Wayne et al. 2004,
Michel & Clark 2009), and that organisational support can be one of the antecedents of WFE (Carlson
et al. 2006). For these reasons, it seems important for
organisations to understand not only how to reduce
WFC, but also how to promote WFE (Bakker et al.
2011, Molino et al. 2013).
Studies of the nursing profession have generally concentrated on WFC rather than WFE (Cortese et al.
2010). Simon et al. (2004) did fundamental work on
this construct as part of the NEXT-Study. The study
found high WFC scores in many of the European
countries considered, the highest being in Italy. Recent
studies also found a high level of WFC among Italian
nurses, and showed that WFC was significantly associated with burnout, sleep problems and presenteeism
(Camerino et al. 2010), as well as with job satisfaction and turnover intentions (Battistelli et al. 2013).
Regarding studies of WFE in health-care organisations, Tummers and Den Dulk (2013) identified relatively high levels of WFE in a sample of Dutch
midwives. The authors demonstrated that work alienation and work pressure negatively influenced WFE.
Russo and Buonocore (2012) examined the relationship between WFE and organisational- and professional-related outcomes, showing that high levels of
WFE were related to lower intentions to leave the
nursing profession.

Job demands, WFC and WFE
Scholars have indicated that job demands are the main
determinants of WFC (O’Driscoll et al. 2006, Molino
et al. 2015). This study considered two specific job
demands related to WFC in the literature: workload
and emotional dissonance. Workload is a general type
of demand consisting of having too much work to do
and not enough time to do it (van Veldhoven & Beijer
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Journal of Nursing Management

2012). Even though workload is a general job
demand, a number of studies considered this variable
in the specific case of samples of nurses and showed a
positive relationship between workload and WFC
(Cortese et al. 2010). The second job demand investigated here is emotional dissonance, a type of demand
specific to people-oriented professions, which consists
of a discrepancy between felt and displayed emotions
(Bakker & Heuven 2006). Bakker and Heuven (2006)
showed that emotional labour and emotional dissonance were linked to burnout, and studies of the nursing profession, as well as other fields, shed light on
the link between emotional dissonance and WFC in
jobs involving frequent contact with the public (Ghislieri et al. 2012).
The link between demands and WFE has rarely been
explored in the literature and is probably more complex. In fact, enrichment hinges mainly on job
resources (Ten Brummelhuis & Bakker 2012), which
help the individual to develop new resources that can
positively influence life outside work. However,
according to the job demands–resources theory (Bakker & Demerouti 2014), job demands can play an
important role in fostering work engagement but may
turn into job stressors when meeting those demands
requires considerable effort from which the employee
does not recover adequately (Meijman & Mulder
1998). In a similar way, high levels of demands that
are not balanced by adequate resources could be
related to lower enrichment.

Work relationships, WFC and WFE
In studies investigating the resources that can mitigate WFC or increase WFE, particular attention has
been devoted to the formal and informal support that
organisations can give their employees (Kossek et al.
2011). The term ‘family-friendly’ is widely used to
denote organisations that show they are supportive
of employees’ needs to accommodate work and family responsibilities by offering benefits to help them
manage multiple life roles (Ghislieri & Colombo
2014).
A number of studies have emphasised the importance of supportive management in reducing WFC
(Cortese et al. 2010). In their survey of hospital
employees, Odle-Dusseau et al. (2012) found that
WFE significantly mediated the relationships between
family supportive supervisor behaviour on the one
hand, and organisational commitment, intention to
leave and supervisor ratings of organisational support
performance on the other.
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C. Ghislieri et al.

A recent study by Lembrechts et al. (2014), carried
out to identify possible antidotes to WFC among hospital nurses, found that organisational support, lack of
workload and the absence of overtime can reduce WFC,
whereas the use of work–family policies does not.
A construct that has been used widely to determine
whether an organisation is generally supportive is perceived organisational support. Eisenberger et al.
(1986), in their first definition of POS, suggested that
employees develop a general perception about the
degree to which organisations appreciate their contributions and care about their well-being. Perceived
organisational support ‘is also valued as assurance
that aid will be available from the organisation when
it is needed to carry out one’s job effectively and to
deal with stressful situations’ (Rhoades & Eisenberger
2002, p. 698). Lastly, previous research considered
POS as a job resource, finding, for instance, that it
had a direct and an indirect effect on extra-role behaviour via the mediation of work engagement (Sulea
et al. 2012), and also buffered the impact of emotional dissonance on disengagement (Karatepe 2011).
Lastly, a very recent paper found that a specific type
of POS – that is to support people utilising their personal strengths at work – buffers the impact of workload and emotional demands on absenteeism (van
Woerkom et al. 2016).
Several studies investigated the relationship between
POS and the work–family interface, intended as either
WFC or WFE. To give some examples regarding ‘conflict’, Casper et al. (2002) found that POS lessened the
harmful effects of WFC on commitment when conflict
was bidirectional (i.e. when it was high in both directions). Dixon and Sagas (2007) found that WFC partially mediated the relationship between POS and job
satisfaction. In a more recent study, Gurbuz et al.
(2012) confirmed that POS had a negative relationship
with WFC (measured with the Netemeyer et al. scale
1996), while role overload did not have a mediating
effect on the relationship between POS and WFC.
Regarding ‘enrichment’, investigations addressed the
buffer effect of POS on the relationship between job
performance on the one hand, and both FWE and
family-to-work conflict on the other (Witt & Carlson
2006). McNall et al. (2011) found, as mentioned in
the introduction, that POS had a strong positive relationship with WFE. Furthermore, in supportive work
environments, individuals reported high WFE, regardless of the dispositional dimension (i.e. core self-evaluations). However, when POS was low, individuals
high in core self-evaluations reported higher WFE
than those low in that dimension.
4

While organisational support has attracted growing
attention in the scientific literature, few studies
addressed work–family backlash. This expression
refers to the opposition, resentment, animosity or
annoyance that workers perceive or receive from
their supervisors or co-workers as a result of their
efforts to balance their work and family lives or their
use of family-friendly benefits (Korabik & Warner
2009, Colombo & Ghislieri 2014). Perceived work–
family backlash can influence WFC and WFE, with
an effect opposite to that of POS. To date, few studies have addressed the possible impact of this variable on issues associated with work–life balance
(Ricotta et al. 2011). Specifically, the scant literature
bears out a difference between supervisor backlash
and co-worker backlash (Ricotta et al. 2011) when
these variables are linked to WFC, even though the
two dimensions are correlated, while there are no
studies that link backlash to WFE. As regards the
distinction between supervisor and co-worker backlash, studies on support also highlighted a difference
between supervisor and colleague support (Cortese
et al. 2010). Despite the high correlation between
these two constructs, research showed that supervisor
support reduces WFC perceptions more than colleague support. Moreover, perceived resentment from
supervisors and colleagues could reduce the freedom
to use work–family facilitations (Parker & Allen
2001) which, consequently, may foster WFC and
reduce WFE.
Based on the scientific literature discussed above,
this study tested the following hypotheses, all of
which applied after controlling the effects of gender
and working hours per week:
H1. Job demands (H1a workload; H1b emotional dissonance) are positively related to
WFC.
H2. Work–family backlash (H2a. supervisor
backlash; H2b. co-worker backlash) is positively related to WFC.
H3. POS is negatively related to WFC.
H4. Job demands (H4a. workload; H4b. emotional dissonance) are negatively related to
WFE.
H5. Work–family backlash (H5a. supervisor
backlash; H5b. co-worker backlash) is negatively related to WFE.
H6. POS is positively related to WFE.
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Work–family conflict and enrichment

Method
Participants and data collection procedures
Participants were nurses working in a hospital in the
north of Italy. The organisation was divided into four
working areas: medicine, surgery, intensive care and
maternal and child health.
A self-reported questionnaire was sent to the 942
nurses working in the hospital. The overall response
rate was 55.1%, a value that is moderately low, but
in line with other studies on nursing (VanGeest &
Johnson 2011). After data cleaning, 500 respondents
remained in the final sample.
The hospital board of directors authorised the study.
The participants signed an informed consent form,
which researchers distributed to the nurses along with
the questionnaires. To guarantee anonymity, respondents returned the questionnaires in drop-boxes provided by the hospital management. A cover letter
attached to the questionnaire described the measures
taken to guarantee anonymity, the voluntary participation and provided guidelines for filling out the questionnaire.
Of the 500 respondents, 84.00% were women with
an average age of 44.09 years (SD 7.06); 64.20% had
a high school diploma, while 22.60% held a bachelor’s or master’s degree. Mean job tenure was
18.93 years (SD 9.56) and most respondents had a
full-time job (82.20%) with an open-ended employment contract (96.00%) for about 35.01 hours per
week (SD 5.17). Regarding working areas, 35.10% of
the respondents worked in intensive care, 33.30% in
medicine, 23.00% in surgery and 8.60% in maternal
and child health.

Measures
All the measures used in this study were adapted in
Italian and/or used in previous Italian studies.
Work–family conflict was assessed with the Italian
version (Colombo & Ghislieri 2008) of the five-item
scale developed by Netemeyer et al. (1996) using a
six-point frequency scale (1 = never, 6 = always). An
example item was ‘The amount of time my job takes
up makes it difficult to fulfil family responsibilities’.
Cronbach’s alpha of this scale was 0.89.
Work–family enrichment was measured using three
items (Ghislieri et al. 2011). An example item was ‘At
work I feel a sense of accomplishment and this helps
me to be a better family member’ (1 = strongly disagree, 5 = strongly agree). Cronbach’s alpha was
0.85.
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Journal of Nursing Management

Workload was measured by four items taken from
Bakker et al. (2004) and used in a previous Italian
study (Molino et al. 2013). An example item was
‘How often do you have to work extra hard in order
to reach a deadline?’ (1 = never, 5 = always). Cronbach’s alpha was 0.79.
Emotional dissonance was assessed with four items
(Zapf et al. 1999) used in a previous Italian study
(Ghislieri et al. 2012). An example item was ‘Display
positive emotions while feeling indifferent’ (1 = never,
6 = always). Cronbach’s alpha was 0.84.
Supervisor backlash was assessed using six items
(Ricotta et al. 2011). An example item was ‘Supervisors make negative comments if someone benefits
from tools aimed at supporting work–family balance’
(1 = disagree, 4 = agree). Cronbach’s alpha was
0.91.
Co-worker backlash was assessed using six items
(Ricotta et al. 2011). An example item was ‘Co-workers make negative comments if someone benefits from
tools aimed at supporting work–family balance’
(1 = disagree, 4 = agree). Cronbach’s alpha was 0.90.
Perceived organisational support was assessed on a
seven-point agreement scale (1 = strongly disagree,
7 = strongly agree). Six items were used from an
eight-item scale (Eisenberger et al. 1997, validated in
Italian by Battistelli & Mariani 2011) because two of
the original items presented lower correlations with
the other items and would have decreased Cronbach’s
alpha. An example item was ‘My organisation really
cares about my well-being’. Cronbach’s alpha was
0.87.

Data analysis
Descriptive analyses, internal reliability of the scales
and correlations between variables were calculated
using the PASW 18 statistical package (IBM, Armonk,
New York, USA). The software was also used to test
the relationship between the variables throughout
hierarchical regression analyses. Specifically, the following variables were entered in the regression analysis: (1) at the first step, gender and working hours as
control variables, (2) at the second step, workload
and emotional dissonance as job demands that are the
main predictors of WFC and can also be important in
the enrichment process (Grzywacz & Marks 2000,
Tement & Korunka 2015); the two dimensions of
work–family backlash – both supervisor and coworker backlash; POS as a job resource based on positive work relationships, mainly associated with
enrichment.
5

C. Ghislieri et al.

Table 3 shows the results of hierarchical multiple
regression with WFE as the dependent variable. The
model shows no relations with gender and working
hours per week at either the first step (corrected R2
0.01) or the second step (corrected R2 0.18). At the
second step, workload and emotional dissonance have
a negative low relation with WFE: b = 0.10 for both
job demands. Perceived organisational support has a
positive high relation with WFE (b = 0.34). No relations were found with either work–family backlash
dimension (supervisor and co-worker).

Results
Table 1 shows descriptive statistics, reliability and correlations among all variables. Analysis shows a negative correlation between WFC and WFE (r = 0.28).
Work–family conflict presents positive correlations
with both job demands (workload, r = 0.28; emotional
dissonance, r = 0.36), supervisor backlash (r = 0.30)
and co-worker backlash (r = 0.19); moreover, the
results show a negative correlation between WFC and
POS (r = 0.28). Work–family enrichment shows negative correlations with both job demands (workload,
r = 0.21; emotional dissonance, r = 0.20), both
backlash dimensions (supervisor, r = 0.19; co-worker
backlash, r = 0.09), and a positive correlation with
POS (r = 0.36). Of the two control variables, working
hours per week presents negative correlations with
female gender (r = 0.22), co-worker backlash
(r = 0.12) and POS (r = 0.15), as well as a low
positive correlation with WFC (r = 0.10). Gender does
not show other significant correlations.
Table 2 shows the results of the hierarchical multiple regression with WFC as the dependent variable.
At the first step (corrected R2 0.01), working hours
per week shows a low positive relation with WFC
(b = 0.11); gender shows no relation with WFC. At
the second step (corrected R2 0.19), the control
variables (gender and working hours per week) do
not show any relation with WFC. As for job
demands, both workload (b = 0.12) and emotional
dissonance (b = 0.22) have a positive relation with
WFC. As for the variables linked to work relationships, of the two backlash dimensions only supervisor backlash has a positive relation with WFC
(b = 0.14), no relations were found with co-worker
backlash; POS has a negative relation with WFC
(b = 0.13).

Discussion
The aim of this study was to explore how work relationships may interact with WFC and WFE in a
Table 2
Results of hierarchical
work–family conflict

regression;

dependent

variable =

WFC
B
Step 1
Gender (1 = F)
Working hours per week
R2
F
Step 2
Gender (1 = F)
Working hours per week
Workload
Emotional dissonance
Supervisor backlash
Co-worker backlash
POS
R2
DR2
F

0.67
0.12
0.01
2.18
0.70
0.07
0.25
0.28
0.16
0.09
0.10
0.19
0.18***
13.78***

ES

b

0.82
0.06

0.04
0.11*

0.82
2.06

0.75
0.06
0.10
0.06
0.06
0.06
0.04

0.04
0.06
0.12*
0.22***
0.14*
0.08
0.13*

0.93
1.23
2.40
4.39
2.49
1.5
2.52

T

*P < 0.05. **P < 0.01. ***P < 0.001. R2 = R-squared. DR2 = delta
R-squared.

Table 1
Item means, item standard deviations and correlations among the study variables

1.
2.
3.
4.
5.
6.
7.
8.
9.

Gender (1 = F)
Working hours per week
WFC
WFE
Workload
Emotional dissonance
Supervisor backlash
Co-worker backlash
POS

M

SD

–
35.01
17.76
8.39
14.12
13.67
13.38
13.74
20.62

–
5.17
5.95
2.98
2.83
4.72
5.22
5.09
7.86

1
–
0.22**
0.06
0.03
0.04
0.03
0.02
0.06
0.02

2

–
0.10*
0.06
0.08
0.08
0.03
0.12*
0.15**

3

4

5

6

7

8

9

(0.89)
0.28**
0.28**
0.36**
0.30**
0.19**
0.28**

(0.85)
0.21**
0.20**
0.19**
0.09*
0.36**

(0.79)
0.29**
0.21**
0.05
0.18**

(0.84)
0.28**
0.12**
0.19**

(0.91)
0.44**
0.32**

(0.90)
0.14**

(0.87)

*P < 0.05; **P < 0.01. Cronbach’s alpha on the diagonal.

6

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Work–family conflict and enrichment

Table 3
Results of hierarchical regression; dependent variable = work–family enrichment
WFE
B
Step 1
Gender (1 = F)
Working hours per week
R2
F
Step 2
Gender (1 = F)
Working hours per week
Workload
Emotional dissonance
Supervisor backlash
Co-worker backlash
POS
R2
DR2
F

0.34
0.05
0.01
2.16
0.33
0.01
0.11
0.07
0.02
0.01
0.13
0.18
0.18***
13.75***

ES

b

T

0.41
0.03

0.04
0.09

0.84
1.65

0.37
0.03
0.05
0.03
0.03
0.03
0.02

0.04
0.01
0.10*
0.10*
0.04
0.02
0.34***

0.89
0.29
2.14
2.07
0.64
0.47
7.05

*P < 0.05. **P < 0.01. ***P < 0.001. R2 = R-squared. DR2 = delta Rsquared.

sample of Italian nurses, with particular focus on general POS and specific work–family backlash, in terms
of both supervisor and co-worker backlash. The study
also considered the relationships of WFC and WFE
with two job demands, workload and emotional
dissonance.
Regarding H1, the results confirmed that job
demands were potential predictors of WFC, in line
with other studies on this subject (O’Driscoll et al.
2006, van Veldhoven & Beijer 2012). In particular,
emotional dissonance was important in work-tofamily interactions: the effort involved in displaying
emotions at work that differ from those that are really
felt might cause spillover effects in other life domains,
confirming results that were also found for other professions (Emanuel et al. 2014).
H2 was partially confirmed. The results of multiple
regression showed that only supervisor backlash was
related to WFC. Therefore, potentially problematic situations might arise, above all in the relationship with
the supervisor, when the need to balance work and
family responsibilities was not given due consideration
and attracted criticism and resentment, if not outright
hostility (Korabik & Warner 2009, Colombo & Ghislieri 2014). Lastly, H3 was also confirmed: POS was
negatively related to WFC (cf. Gurbuz et al. 2012).
Regarding WFE, H4 was confirmed: both job
demands (workload and emotional dissonance) were
negatively related to WFE, in line with previous studies that found job demands as predictors of WFE in
ª 2016 John Wiley & Sons Ltd
Journal of Nursing Management

heterogeneous samples (Grzywacz & Marks 2000,
Tement & Korunka 2015).
H5, on the other hand, was not confirmed: work–
family backlash (neither supervisor nor co-worker
backlash) was not related to WFE. Thus, it seems that
WFE was not affected by negative aspects of the relationship, but was heavily influenced by the support
received in the organisation. Although some job
demands showed negative relationships with WFE,
also in Italian studies that considered the nursing context (e.g. working hours per week; Ghislieri et al.
2011), WFE was mainly associated with job resources,
particularly the support received from supervisors and
colleagues. This aspect was congruent with the contribution by Greenhaus and Powell (2006), who highlighted, in particular, the improvement process due to
resources from the work domain and reported positive
relationships between WFE and a supportive and flexible work environment, networking in the organisation
and acceptance by peers. Moreover, also in this study,
the support aspect of the job seemed to be particularly
able to foster enrichment.
H6 was in fact confirmed: POS showed a strong,
positive and significant relationship with WFE. This
result was in line with the finding by McNall et al.
(2011), who demonstrated that POS was a significant
antecedent of WFE. Furthermore, the authors showed
that respondents who perceived high POS reported
higher levels of WFE, regardless of other variables,
such as the personality dimension of core self-evaluations. The latter variable, however, was significantly
related to WFE at low and medium levels of POS.
Since POS ‘serves an important socioemotional function’ (Rhoades & Eisenberger 2002, p. 710) and has a
strong positive relationship, for instance, with a positive mood, we might hypothesise that this variable
powered the affective path toward enrichment (Greenhaus & Powell 2006). Nurses who felt more support
from their organisation perceived higher positive emotions toward their job that, in turn, allowed them to
perceive higher positive emotions in their family role.

Conclusions
The study addressed work–family balance in the nursing profession, considering both WFC and WFE.
With regard to WFC, the study confirmed the
important role of job demands, but also indicated that
POS can have a direct impact on mitigating WFC
(Gurbuz et al. 2012), whereas supervisor backlash can
potentially intensify WFC.

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C. Ghislieri et al.

In relation to WFE, the role of POS appeared to be
crucial (McNall et al. 2011), which seemed to enable
people to see their jobs as an experience that generates
resources, which could improve the quality of personal and family life. Although the study did not compare this element with formal aspects and concrete
solutions, it nevertheless pointed to the importance of
perceptions about the quality of support received from
the organisation.
The study is therefore a contribution to the literature in this area as few studies to date have considered
both conflict and enrichment among Italian nurses
and explored the influence of work relationships on
these outcomes. However, it also has certain limitations. First, participants were nurses at the same hospital. Comparison with other hospitals, and in other
regions, would be advisable in future research. Moreover, it is also possible that our findings were influenced by cultural characteristics that are specific to
Italy. For this reason, it would be instructive to replicate the study in other cultural contexts (Biggio &
Cortese 2013, Cortese 2013).
Moreover, the cross-sectional research design relying
on self-reported data means that results may be
affected by common method variance, and an
unequivocal interpretation of the causal relationships
is therefore not possible (Conway 2002, Podsakoff
et al. 2003). Future work should combine selfreported data with measures from other sources or
other observers (e.g. supervisors and/or co-workers)
and employ longitudinal designs (Polit & Beck 2004).
Lastly, the relationships with supervisors and coworkers should be investigated in greater depth to
determine how they are linked to work–family balance, and how they may both help and hinder it. Preliminary qualitative studies, particularly in-depth
interviews, would also prove useful for this purpose.

Implications for nursing management
Action on the dimensions that could mitigate WFC
and increase WFE (workload, emotional dissonance,
supervisor backlash and POS) should be taken at individual, team and organisational levels. Before describing these actions, it is important to underline that they
do not always call for major financial outlays: targeted investments should also be made on initiatives
focusing on communicational, relational and cultural
dimensions.
Actions at the individual level are mainly those
aimed at reducing workload perceptions through the
ability to manage the workload itself. The focus
should be on perceptions, since reducing the quantity
of work tasks is not practicable nowadays, partly
because of the hiring freeze caused by the contemporary economic crisis that has increased duties, shifts
and time pressure (Cortese 2013). With regard to this,
it is important to consider that having greater autonomy and being more aware about responsibilities,
aims and priorities at work could help nurses to manage their job activities and to decrease workload perceptions (Zito et al. 2016).
Measures to reduce emotional dissonance can be
taken at both individual and team level. In particular, the study’s findings indicate that it is essential to
devote attention to the emotional commitment and
demands of the hospital environment where nurses
exercise their profession. Individual training initiatives designed to help nurses to develop coping skills
and to gain an appropriate emotional distance from
their job could contribute to lightening this burden.
In the same way, small group counselling for current
teams should make members capable of giving
mutual support (Pizam 2004). In particular, this support could be achieved by providing an opportunity

Table 4
Three levels of nursing management actions and related expected outcomes

Individual level

Actions

Target variables

Higher autonomy in job activities
More awareness about own working
priorities, tasks and goals
Individual training initiatives

Decreasing workload perceptions

Decrease of WFC
Increase of WFE

Decreasing emotional dissonance

Decrease of WFC
Increase of WFE
Decrease of WFC

Decreasing supervisor backlash

Team level

Counselling and coaching for nursing
directors and head nurses
Teamwork counselling

Organisational level

Teamwork training initiatives
Introducing work–family benefits

Decreasing supervisor backlash
Increasing POS

8

Decreasing emotional dissonance

Expected outcomes

Decrease of WFC
Increase of WFE
Decrease of WFC
Decrease of WFC
Increase of WFE

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Journal of Nursing Management

Work–family conflict and enrichment

to express the discomfort related to emotional dissonance during interactions with colleagues, thus gaining relief.
At both the individual and team level, measures can
also be taken to reduce supervisor backlash. In this
respect, some efforts must be made to raise awareness
of this problem among nursing directors and head
nurses in order to ensure that they are not perceived as
obstacles to the work–life balance – involuntary or
otherwise – because of inadequate communication with
the nurses they manage. It is thus important to help
supervisors to engage in supportive behaviour that can
be conducive to a family-friendly culture and to serve
as an additional resource for increasing WFE (Molino
et al. 2013). To this end, teamwork-training initiatives
could also be accompanied by individual counselling,
coaching and mentoring (Ghislieri & Gatti 2012).
Lastly, as far as the organisational level is concerned, introducing work–family benefits and ensuring
employees are aware of them can be useful in increasing POS. This will mean providing information and
training on work–family balance, through counselling
groups or hot lines, and developing solutions targeted
at the expressed needs of employees (Amstad et al.
2011).
Table 4 summarises the actions suggested in this
paragraph, the target variables and the expected outcomes based on the study framework.

Source of funding
No funding was received for this study.

Ethical approval
This study was approved by the hospital board of
directors which gave permission to conduct the
research.

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