{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T09:15:40Z","timestamp":1789809340927,"version":"4.0.1"},"reference-count":40,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T00:00:00Z","timestamp":1789776000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T00:00:00Z","timestamp":1789776000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000056","name":"National Institute of Nursing Research","doi-asserted-by":"publisher","award":["R01NR014855; T32NR007104"],"award-info":[{"award-number":["R01NR014855; T32NR007104"]}],"id":[{"id":"10.13039\/100000056","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["shmpublications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Hospital Medicine"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The nurse practitioner (NP) workforce is rapidly expanding in hospital settings, yet limited evidence exists on how organizational practice environments influence NP burnout. Identifying modifiable workplace factors is critical to improving NP well\u2010being and retention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine the associations between dimensions of the NP practice environment and burnout among hospital\u2010based NPs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross\u2010sectional observational study used data from the 2024 Penn Nurses4All Study. The analytic sample included 1405 NPs working in hospital settings. The independent variables were the four dimensions of NP practice environment (i.e., professional visibility, NP\u2010administration relations, NP\u2010physician relations, and independent practice and support), and the dependent variable was burnout. Structural equation modeling was conducted to examine associations between the practice environment and burnout, adjusting for age, sex, employment status, and work setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the 1405 hospital\u2010based NPs, the mean age was 50.3 years (SD\u2009=\u200911.2). Most respondents were female (87.1%) and worked full\u2010time (83.9%). Approximately 28.2% worked in emergency department or intensive care unit settings. More favorable practice environment domains, including professional visibility (standardized coefficient\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u2009\u2212.15,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.035), NP\u2013administration relations (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u2009\u2212.36,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001), and NP\u2013physician relations (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u2009\u2212.22,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001) were significantly associated with lower burnout. Independent practice and support were not significantly associated with burnout.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Organizational features of the practice environment play a central role in shaping burnout among hospital\u2010based NPs. Strengthening leadership engagement, interprofessional collaboration, and NP integration within healthcare organizations may be key strategies to reduce burnout and improve workforce retention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jhm.70482","type":"journal-article","created":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T08:41:51Z","timestamp":1789807311000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Organizational determinants of burnout among hospital\u2010based nurse practitioners: A structural equation modeling analysis"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6770-0808","authenticated-orcid":false,"given":"Hyunmin","family":"Yu","sequence":"first","affiliation":[{"name":"Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania Philadelphia Pennsylvania USA"},{"name":"Leonard Davis Institute of Health Economics, University of Pennsylvania Philadelphia Pennsylvania USA"},{"name":"Penn Presbyterian Medical Center Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0529-8171","authenticated-orcid":false,"given":"Lusine","family":"Poghosyan","sequence":"additional","affiliation":[{"name":"Columbia School of Nursing New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4295-6372","authenticated-orcid":false,"given":"Heather","family":"Brom","sequence":"additional","affiliation":[{"name":"Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania Philadelphia Pennsylvania USA"},{"name":"Leonard Davis Institute of Health Economics, University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3279-4162","authenticated-orcid":false,"given":"Kristin H.","family":"Gigli","sequence":"additional","affiliation":[{"name":"College of Nursing and Health Innovation, University of Texas at Arlington Arlington Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4573-5702","authenticated-orcid":false,"given":"Corinna","family":"Sicoutris","sequence":"additional","affiliation":[{"name":"Hospital of the University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Baglieri","sequence":"additional","affiliation":[{"name":"Penn Medicine Medical Group Bala Cynwyd Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew D.","family":"McHugh","sequence":"additional","affiliation":[{"name":"Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania Philadelphia Pennsylvania USA"},{"name":"Leonard Davis Institute of Health Economics, University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,19]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"US Bureau of Labor Statistics. 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