Iran Journal of Nursing

Introduction
In today’s society, fundamental changes in the nature of work and family structure have significantly complicated the roles of individuals in the workplace and personal life. A notable change is the increased participation of women in the workforce, which has made it more difficult to manage work and family roles, often disrupting the balance between these domains. Despite these changes, employees, including nurses, are expected to effectively balance work and family expectations, but these expectations often lead to work-family conflict, a phenomenon that occurs when work responsibilities interfere with family obligations, or vice versa. Such conflict has adverse effects, including decreased job satisfaction, heightened stress levels, and increased turnover intentions. This conflict is especially intense in stressful jobs such as nursing, which require non-stop activity and shift work.
Workplace well-being (WWB), an essential aspect of organizational health, encompasses employees’ physical, mental, and social wellness, and can affect their quality of life and work performance. Research has shown that WWB is beneficial not only for employees but also for organizations and communities, as it helps increase productivity, reduce absenteeism, and improve organizational performance. Work-family conflict can reduce WWB, particularly among nurses, due to long working hours, high psychological pressure, and non-standard work shifts. In contrast, work-family culture, defined as an organization’s values and practices that support the integration of employees’ work and family life, can mitigate this conflict and promote WWB. 
Studies have shown that work-family conflict acts as a mediator between work-family culture and PWB. There is scant research on the mediating role or the broader influence of work-family culture in Iran. Given nursing’s critical role in healthcare and the substantial costs associated with turnover due to work-family pressures, understanding the factors that improve nurses’ WWB is important. Therefore, this study aims to examine the impact of work-family culture on the WWB of nurses in public hospitals of Tehran, Iran with a specific focus on the mediating role of work-family conflict. The research hypotheses are:  1) Work-family culture significantly affects WWB; 2) Work-family conflict significantly affects WWB; 3) Work-family culture significantly reduces work-family conflict; 4) Work-family conflict mediates the relationship between work-family culture and WWB. 

Methods
This is a descriptive-correlational study. The study population consists of 200 nurses working in public hospitals that provide care for COVID-19 patients in Tehran, Iran. Using the Krejcie-Morgan table, a sample size of 127 was determined and a stratified proportional sampling method was used to ensure representation across hospitals and departments. Data collection took place between October and November 2023 in selected hospitals, using three validated instruments: Thompson et al.’s [20] work-family culture scale, Carlson et al.’s [22] work-family conflict scale, and Page’s WWB Scale. The work-family culture scale has 20 items rated on a 5-point Likert scale, assessing managerial support, negative career consequences, and organizational time demands. The work-family conflict scale has 18 items, measuring work-to-family conflict and family-to-work conflict at three domains of time, strain, and behavior. The WWB scale has 14 items that evaluate emotional, psychological, and social well-being. Data analysis was conducted in SmartPLS software, version 3 using the structural equation modeling (SEM) with a partial least squares (PLS) approach. Descriptive statistics, including mean, standard deviation were calculated using SPSS software, version 25. The significance of the mediating role of work-family conflict was evaluated using the bootstrap method.

Results 
Participants were 127 nurses (54.5% female, 45.5% male), with the majority aged 31-40 years (41%) and married (58%). Also, 43% had a bachelor’s degree. Descriptive statistics indicated a moderately high work-family culture (Mean=4.29) and WWB (Mean=4.21), suggesting a relatively positive status in these areas. However, the work-family conflict was high (Mean=4.22), reflecting significant challenges in achieving work-life balance among nurses.
The SEM analysis revealed several key results. Work-family culture had a significant positive effect on WWB (β=0.806, t=10.112, P<0.001), supporting the first hypothesis. Work-family conflict demonstrated a significant negative effect on WWB (β=-0.448, t=-4.302, P<0.001), confirming the second hypothesis. Additionally, work-family culture significantly reduced work-family conflict (β=-0.588, t=-6.752, P<0.01), confirming the third hypothesis. The mediating role of work-family conflict in the relationship between work-family culture and WWB was confirmed, with a significant indirect effect (β=0.20, P<0.05). Model fit indices were robust, with composite reliability and Cronbach’s α exceeding 0.7, average variance extracted (AVE)>0.5, and a goodness-of-fit index (GOF) of 0.53, above the minimum threshold of 0.36. These findings confirm the structural relationships in this study.

Conclusion
This work-family culture significantly enhances the WWB of nurses in public hospitals by reducing work-family conflict. The strong positive association between work-family culture and WWB, mediated by a reduction in work-family conflict, highlights the pivotal role of a supportive organizational culture in healthcare settings. Practically, hospital managers should prioritize cultivating a work-family culture through flexible scheduling, providing emotional support services to nurses, and policies that acknowledge nurses’ family responsibilities. Regular monitoring of nurses’ WWB and work-family conflict levels is needed for developing targeted interventions for them. Future research should explore specific organizational interventions—such as tailored shift policies or support programs—and their direct impact on reducing work-family conflict and enhancing WWB. Investigating other variables, such as financial stress or social support networks, could provide a more comprehensive understanding of nurses’ WWB. Longitudinal studies are also recommended to assess the sustained effects of work-family culture over time, offering deeper insights into its role in fostering resilience and performance among nurses.

Ethical Considerations
Compliance with ethical guidelines
The research was approved by the Ethics Committee of Payame Noor University (Code: IR.PNU.REC.1401.490), and participation was voluntary, with informed consent obtained from all respondents.

Funding
The paper was extracted from the MSc thesis of Majid Zakeri, Department of Management, Faculty of Management, Economics, and Accounting, Payame Noor University. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Authors' contributions
All authors contributed equally to the conception and design of the study, data collection and analysis, interpretation of the results, and drafting of the manuscript. Each author approved the final version of the manuscript for submission.

Conflict of interest
The authors declared no conflict of interest.

Acknowledgments
The authors of the present study sincerely thank the nurses and managers of Tehran hospitals for their valuable cooperation in this research.


References

1. Bolandian Bafghi S. [Work-family conflict in Iranian nurses: A systematic review (Persian)]. Iran J Nurs Res. 2020; 14(6):53-60. [Link]
2. Lanaj K, Foulk TA, Erez A. Energizing leaders via self-reflection: A within-person field experiment. J Appl Psychol. 2019; 104(1):1-18. [DOI:10.1037/apl0000350] [PMID]
3. Mousavinia SM, Naami A, Arshadi N, Beshlideh K. [The role of employees' wellbeing in reducing the effects of work-family conflict on family satisfaction, parenting quality, and couple relationship quality in nurses (Persian)]. Iran J Nurs. 2020; 33(124):41-57. [DOI:10.29252/ijn.33.124.41]
4. Dargah S, Haghani Zemydani M, Ghalavand M. [The relationship between work-family conflict and work ethics with mediating role of job stress in nurses (Persian)]. Iran J Med Ethics Hist Med. 2017; 10:44-54. [Link]
5. Dehghani Soltani M,  Joneidi Jafari M. [The impact of work engagement on well-being and control at work: Mediating role of psychological capital (Persian)]. Manage Stud Dev Evol. 2020; 29(95):161-85. [DOI:10.22054/jmsd.2020.41761.3288]
6. Torri P, Toniolo E. [Organizational wellbeing: challenge and future foundation (Italian)]. G Ital Med Lav Ergon. 2010 Jul-Sep;32(3):363-7. [PMID]
7. Garg N. Workplace spirituality and employee well-being: An empirical examination. J Hum Values. 2017; 23(2):1-15. [DOI:10.1177/0971685816689741]
8. Nielsen K, Nielsen MB, Ogbonnaya C, Känsälä M, Saari E, Isaksson K. Workplace resources to improve both employee well-being and performance: A systematic review and meta-analysis. Work Stress. 2017; 31(2):101-20. [DOI:10.1080/02678373.2017.1304463]
9. Yang X, Kong X, Qian M, Zhang X, Li L, Gao S, et al. The effect of work-family conflict on employee well-being among physicians: The mediating role of job satisfaction and work engagement. BMC Psychol. 2024; 12(1):530. [DOI:10.1186/s40359-024-02026-8]
10. Putri HE, Etikariena A. The role of the work-family conflict in the relationship between work-family culture and employee well-being. J Psikol. 2020; 19(3):257-68. [Link]
11. Michaeli Manee F, Khalili M, Kazemifard D. [Predicting of Job Burnout Based On subjective well-being, psychological capital, demand and resources job in nurses (Persian)]. Med J Mashhad univ Med Sci. 2023; 66(5):1193-205. [Link]
12. Jun J, Ojemeni MM, Kalamani R, Tong J, Crecelius ML. Relationship between nurse burnout, patient and organizational outcomes: Systematic review. Int J Nurs Stud. 2021; 119:103933. [DOI:10.1016/j.ijnurstu.2021.103933] [PMID]  
13. Movahed A, Abbasi Z. [The role of psychological empowerment dimensions in predicting the psychological well-being of healthcare network employees (Persian)]. J Healthc Manag Res. 2019; 10(1):53-66. [Link]
14. Busick AH. Work-family conflict and burnout in healthcare: A qualitative study [ PhD dissertation]. Abilene (TX): Abilene Christian University; 2024. [Link]
15. Radmard S G, nargesian A, Asgari N, Fayyazi M. [Presenting sustainable work-life balance (A study in petroleum industry) (Persian)]. Strategic Stud Oil Energ Indust. 2024; 16(62):3-3. [Link]
16. Wang J, Zhao S, Tong X, Wang M, Wang Y. Work-family conflict among primary health workers during the COVID-19 pandemic: Its mediating role in the relationship between workload and job burnout. J Clin Nurs. 2024; 33(10):3933-42. [DOI:10.1111/jocn.17035] [PMID]  
17. Prasad KDV, Vaidya RW, Rao Mangipudi M. Effect of occupational stress and remote working on psychological well-being of employees: An empirical analysis during covid-19 pandemic concerning information technology industry in Hyderabad. Ind J Commer Manag Stud. 2020; 11(2):1-13. [Link] 
18. Creswell JW, Creswell JD. Research design: Qualitative, quantitative, and mixed methods approaches. 5th ed. Thousand Oaks: Sage Publications; 2018. [Link]
19. Krejcie RV, Morgan DW. Determining sample size for research activities. Educ Psychol Meas. 1970; 30(3):607-10. [DOI:10.1177/001316447003000308]
20. Thompson CA, Beauvais LL, Lyness KS. When work-family benefits are not enough: The influence of work-family culture on benefit utilization, organizational attachment, and work-family conflict. J Vocat Behav. 1999; 54(3):392-415.  [DOI:10.1006/jvbe.1998.1661]
21. Page K. Subjective wellbeing in the workplace [Bachelor thesis]. Geelong: Deakin University; 2005. [Link]
22. Carlson DS, Kacmar KM, Williams LJ. Construction and initial validation of a multidimensional measure of work-family conflict. J Vocat Behav. 2000; 56(2):249-76. [DOI:10.1006/jvbe.1999.1713]
23. Hajrasuliha M, Oreyzi HR. [Relationship between family-work culture with work and family overlap through supporting head manager among the personnel of Iranian poly acrylic company (Persian)]. J Fam Res. 2016; 12(2):237-50. [Link]
24. Putri HE, Etikariena A. The role of the work-family conflict in the relationship between work-family culture and employee well-being. J Psikologi. 2020; 19(3):257-68. [DOI:10.14710/jp.19.3.257-268]
25. Fatmawati L, Wicaksono DA. Hubungan work-family culture terhadap work-family conflict pada karyawan work from home. J Fenomena. 2021; 30(1):31-8. [Link]
26. Navabi SS, Pourmiri M. [The effect of effort-reward imbalance (ERI) on work-life conflict (WLC) with the mediating role of mental well-being (Case: Official employees and faculty member of Islamic Azad University of Isfahan (Khorasgan)) (Persian)]. Knowl Res Appl Psychol. 2021; 21(4):33-45. [Link]
27. Blom R, Jaspers E, Knies E, van der Lippe T. Family-friendly policies and workplace supports: A meta-analysis of their effects on career, job, and work-family outcomes. J Vocat Behav. 2025; 157:104091. [DOI:10.1016/j.jvb.2025.104091]
28. Johari J, Tan FY, Zulkarnain ZIT. Autonomy, workload, work-life balance and job performance among teachers. Int J Educ Manag. 2018; 32(1):107-20. [DOI:10.1108/IJEM-10-2016-0226]
29. Homayouni A, Seifi Z, Mortazavi N. [The prediction of occupational well-being based on religious coping styles, psychological capital and work-family conflict (Persian)]. Islam Lifestyle Focus Health. 2019; 3(3):22-31. [Link]
30. Bobbio A, Canova L, Manganelli AM. Organizational work-home culture and its relations with the work-family interface and employees' subjective well-being. Appl Res Qual Life. 2022; 17(5):2933-66. [DOI:10.1007/s11482-022-10048-w] [PMID]
31. Carvalho VS, Chambel MJ, Neto M, Lopes S. Does work-family conflict mediate the associations of job characteristics with employees' mental health among men and women? Front Psychol. 2018; 9:966. [DOI:10.3389/fpsyg.2018.00966] [PMID]