# Work-related factors and mental health among home care nurses identified by two-step cluster analysis

## TL;DR

The study identifies work-related factors affecting the mental health of home care nurses and classifies them into two distinct groups based on their mental health status.

## Contribution

The novel use of two-step cluster analysis reveals distinct mental health profiles among home care nurses and their associated job demands.

## Key findings

- Emotional demands and higher work intensity increase the likelihood of being in the 'unhealthy' cluster.
- Social support from colleagues and supervisors increases the likelihood of being in the 'healthy' cluster.
- Targeted interventions are needed to improve mental health and care quality for home care nurses.

## Abstract

Home care nursing gains in importance due to demographic changes. The aim of our study was to explore the associations between home care-nurses’ work situation and their mental health. Data were analysed from a cross-sectional survey of 976 home care nurses recruited from a full sample of invited home care services in Germany. First a descriptive analysis of the work and health situation was carried out. Second a two-step cluster analysis was performed to classify home care nurses based on work-related mental health parameters (irritation, burnout, work engagement). The predicting job demands on basis of the JDR-model in each cluster were analysed via multiple logistic regression. Two clusters (“healthy” and “not healthy”) with significant differences regarding the mental health parameters emerged. Emotional demands and higher work intensity increase the likelihood for home care nurses of being classified in Cluster 1 (“unhealthy”) while social support from colleagues and supervisors increases the likelihood for home care nurses of being classified in Cluster 2. There is an urgent need to develop and implement targeted interventions for home care nurses to cope with emotional demands, reduce their work intensity and improve social support. Only by improving these working conditions home care nurses’ mental health and therefore care quality can be secured.

The online version contains supplementary material available at 10.1038/s41598-026-39178-z.