Exploring the coping mechanisms of Nurse Educators towards Work-Life Balance

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This qualitative exploratory preprint studied coping mechanisms and work-life balance (WLB) strategies among 16 Nurse Educators at a single nursing education institution in Gauteng, using semi-structured face-to-face interviews and thematic analysis, grounded in Spillover Theory. Participants described three main coping themes: creating boundaries between work and personal life, opting to miss work through planned or unplanned sick leave to manage exhaustion, and utilizing support systems from departmental heads, colleagues, and family for emotional and practical help. The authors note that the study is limited by its single-institution context and small, purposive sample, and it has not been peer reviewed. This paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Understanding their coping mechanisms is crucial for promoting work-life balance, enhancing job satisfaction, and ensuring sustainable workforce retention. Methods A qualitative, exploratory design was used. The aim was to explore coping mechanisms for work-life balance. Semi-structured interviews were conducted with 16 Nurse Educators. The educators were from the Nursing Education Institution in Gauteng. The data were interpreted using thematic analysis. Results Three primary themes emerged: 1) Creating Boundaries: Participants consciously separated work from personal life by not taking work home, ignoring after-hours communications, and avoiding non-urgent online meetings. 2) Opting to Miss Work: Nurse Educators used absenteeism, including planned and unplanned sick leave, as a strategy to manage exhaustion and restore balance. 3) Utilizing Support Systems: Nurse Educators sought support from structures such as Heads of Departments, colleagues, and family members for emotional and practical assistance. Conclusion Nurse Educators employed boundary-setting, strategic absenteeism, and institutional and familial support to cope with work-life balance pressures. Enhancing institutional support systems and promoting strategies to protect personal time may mitigate burnout and improve educator work-life balance. Coping Mechanisms Work-Life Balance Nurse Educators Background The global healthcare environment relies heavily on competent Nurse Educators ( 1 ). These professionals occupy a critical and demanding role, tasked with bridging theoretical knowledge and clinical practice while navigating the inherent pressures of academic life ( 2 ). This complex interplay of responsibilities frequently blurs the boundaries between professional and personal domains, placing Nurse Educators at a high risk for chronic stress, burnout, and attrition ( 3 ). Understanding the strategies they employ to manage these pressures is therefore an academic exercise, a crucial imperative for promoting Nurse Educator well-being and ensuring the long-term sustainability of the nursing workforce ( 4 ). This study aims to explore the coping mechanisms and support systems utilized by Nurse Educators to achieve work-life balance (WLB) within a Nursing Education Institution (NEI) in Gauteng, South Africa. Nurse Educators find themselves at the crossroads of two intense fields: healthcare and academia ( 5 ). Their responsibilities extend beyond lecturing to include designing curricula, supervising clinical practice, conducting research, and managing administrative tasks—all often with limited resources and growing student numbers ( 3 ). Managing these varied roles can create significant conflicts between work and personal life, contributing to emotional exhaustion, depersonalization, and a decline in personal achievement—key components of burnout ( 6 ). The impact of this imbalance goes beyond individual educators. Burnout has been linked to reduced job satisfaction, lower teaching quality, and increased intentions to leave among health sciences faculty, which in turn intensifies workloads for remaining staff, creating a harmful cycle ( 7 ). This highlights the urgent need to prioritize Nurse Educators' WLB as an ethical responsibility and a strategic approach to maintain the quality and stability of nursing education. While the problem of WLB is widely acknowledged, the lived experiences of Nurse Educators, particularly in the Global South, remain under-researched. Much of the existing literature focuses on clinical nurses or academics in other disciplines. However, the unique context of nursing education—with its dual commitment to theoretical rigor and practical skill development—demands a focused investigation ( 8 ). Understanding the proactive and reactive coping mechanisms that Nurse Educators themselves employ is essential for developing targeted support systems. Preliminary evidence suggests that strategies may range from individual-level efforts, such as deliberate boundary-setting between work and home life, to seeking organized institutional support ( 9 ). This study aims to fill this gap by providing the coping mechanisms Nurse Educators use to navigate their work-life challenges, thereby offering evidence-based insights for institutional policy and fostering a supportive professional environment. Theoretical framework This study is grounded in Spillover Theory ( 10 ), which provides insight into how work and personal life influence each other. For Nurse Educators, coping mechanisms are essential to managing the Spillover effects, particularly when academic duties and administrative responsibilities intrude on family time, causing negative Spillover ( 11 ). Positive Spillover occurs when energy and satisfaction gained from work enhance personal life, supporting mental health and overall well-being ( 12 ). Employing strategies such as setting boundaries, seeking institutional support, and practicing mindfulness can promote positive Spillover, improving job satisfaction and personal fulfillment ( 13 ). NEIs must implement policies that clearly separate work and personal time and provide access to mental health resources, reducing negative Spillover and fostering a WLB ( 14 ). Aligning institutional policies with Spillover Theory principles enhances the capacity of Nurse Educators to manage their roles effectively, benefiting both their well-being and the wider healthcare education system ( 15 ). Methods This study utilized a qualitative, descriptive approach to explore the under-researched coping mechanisms and support systems for WLB among Nurse Educators in Gauteng province. This methodology was chosen for its ability to capture detailed accounts of lived experiences in natural settings, offering a deeper understanding of the real-world strategies employed by this population ( 16 ). This study adopted a qualitative design, conducted within a specific NEI in Gauteng province. This approach was ideal for gathering rich, in-depth data on WLB strategies within the real-world environment where they are employed ( 17 , 18 ). By focusing on a single, government-funded NEI, the study could explore the unique institutional factors that influence the support systems and coping mechanisms available to Nurse Educators. Population and Sampling The study population included all Nurse Educators at the selected NEI in Gauteng. To ensure participants had relevant experiences to share regarding WLB coping mechanisms, specific criteria were applied. Participants were required to have at least six months of teaching experience at a campus offering nursing programmes longer than six months. Those involved solely in curriculum development or who were unavailable were excluded. A non-probability purposive sampling technique was used to select participants who were knowledgeable and experienced in navigating the challenges of WLB as Nurse Educators. The final sample size was 16 participants, determined by the principle of data saturation ( 19 ). Saturation, the point where no new themes emerged, was observed after the 13th interview. Three additional interviews were conducted to confirm this, ensuring a comprehensive and rigorous exploration of the coping mechanisms and support systems. Data Collection Data were collected through face-to-face, semi-structured interviews using an interview guide with open-ended questions. The questions were developed by the researchers. This method was chosen to facilitate detailed discussions and allow for probing, enabling participants to elaborate deeply on their personal coping mechanisms and the support systems they utilize ( 16 ). Following ethical approval, participants were recruited and provided with written informed consent, which included permission for audio recording. Interviews, conducted in English in private settings for 30–45 minutes, focused explicitly on exploring the Nurse Educators' experiences with WLB, the coping mechanisms they employ to manage it, and institutional support. Data Analysis The data were analyzed using Braun and Clarke's thematic analysis ( 20 ), a method well-suited for identifying, analyzing, and reporting patterns (themes) related to coping mechanisms and support structures. The process began with verbatim transcription and immersion in the data. Through open coding, the researcher identified initial patterns related to how Nurse Educators manage WLB. To ensure the reliability of the themes related to mechanisms and support systems, an independent coder analyzed the data separately. The researcher and coder then collaboratively discussed and refined the codes until a consensus was reached on the final thematic structure. This rigorous process resulted in the identification of three themes, each with three sub-themes, that comprehensively describe the coping mechanisms and support systems for WLB among the Nurse Educators. Trustworthiness The trustworthiness of this study, which is essential when exploring personal narratives about coping mechanisms and support systems, was rigorously established using Polit and Beck's framework ( 19 ). Credibility, ensuring the accurate identification of genuine strategies and support structures, was built through prolonged engagement with the field, peer review of emerging themes, and triangulation of data sources. Ongoing guidance from experienced qualitative researchers further ensured the findings authentically represented the participants' experiences. Transferability was supported by providing a thick, detailed description of the research context, participant group, and identified coping mechanisms, enabling readers and other researchers to assess the applicability of the findings to similar NEIs and populations. Dependability was achieved by maintaining a clear audit trail of all research decisions and employing a pre-tested, consistent interview guide focused on WLB coping mechanisms, ensuring the research process was logical, traceable, and potentially replicable. Confirmability, safeguarding that findings were rooted in the data provided by the Nurse Educators rather than researcher bias, was strengthened through independent coding. An independent coder analyzed the transcripts, followed by a consensus discussion to align themes and sub-themes related to support systems, as recommended by Gray and Grove ( 16 ). This process verifies that the reported mechanisms genuinely derive from participant experiences. Authenticity was demonstrated by faithfully presenting the participants’ voices through verbatim quotes, illustrating their personal coping mechanisms and views on institutional support, thereby ensuring a fair and balanced representation of their lived experiences. Ethical Considerations The study was guided by core ethical principles to protect participants who shared sensitive information about their professional and personal lives. Respect for human dignity was maintained by ensuring participation was entirely voluntary, with all Nurse Educators providing written informed consent after receiving full disclosure about the study's purpose. Beneficence was prioritized by minimizing potential discomfort through confidentiality and conducting interviews in a safe and private environment. Justice was upheld by rigorously protecting participants’ privacy through anonymity and confidentiality, with all data de-identified using coded pseudonyms. Scientific integrity was ensured by recording, analyzing, and reporting data honestly to represent the support systems and coping strategies discussed accurately. Results The findings revealed that Nurse Educators employ a range of distinct yet interconnected coping mechanisms to achieve WLB. These approaches were characterized by efforts to separate professional and personal domains, strategic disengagement, and active seeking of support. The demographic data for the study participants are presented in Table 1 below. Table 1 Demographic data Experience Experience Experience Experience Experience 11 years 11 years 11 years 11 years 11 years 8 years 8 years 8 years 8 years 8 years 11 years 11 years 11 years 11 years 11 years 9 years 9 years 9 years 9 years 9 years 21 years 21 years 21 years 21 years 21 years 14 years 14 years 14 years 14 years 14 years 16 years 16 years 16 years 16 years 16 years 4 years 4 years 4 years 4 years 4 years 11 years 11 years 11 years 11 years 11 years 18 months 18 months 18 months 18 months 18 months 8 years 8 years 8 years 8 years 8 years 16 years 16 years 16 years 16 years 16 years 8 years 8 years 8 years 8 years 8 years 7 years 7 years 7 years 7 years 7 years 18 years 18 years 18 years 18 years 18 years 18 months 18 months 18 months 18 months 18 months Based on the provided Table 1 of demographic data, the study's findings on WLB coping mechanisms are derived from a cohort of 16 predominantly female (93.75%), highly experienced, and mature Nurse Educators (average age ~ 53 years), all of whom hold specialized academic qualifications, suggesting that the identified strategies reflect well-developed, personal approaches honed over time by seasoned professionals deeply familiar with institutional demands, though the insights may be less representative of the challenges faced by younger, early-career, or male educators. Table 2 Themes and subthemes Theme Subtheme 1. Creating boundaries 1.1 Not checking work messages, emails, or attending online meetings outside work hours. 2. Opting to miss work 2.1 Absenteeism from work by booking and planning sick leave 3. Utilization support systems 3.1 Managers, colleagues, and family members Table 2 highlights three main themes and subthemes from the findings related to coping mechanisms: creating boundaries, being compelled to miss work, and utilizing institutional support. Nurse Educators play a vital role in shaping the future of nursing by teaching their students essential knowledge and skills. However, participants faced challenges that led to an imbalanced work-life outlook due to the demanding nature of their roles. This situation contributed significantly to feelings of stress and burnout. In response, participants developed and employed specific coping mechanisms to manage their WLB. Theme 1: Creating boundaries. The sub-theme showed that participants learned not to take work home and to do their best to finish their duties during work hours. Some participants would ignore WhatsApp messages from management while at home and avoid online meetings. Additionally, some would not respond to phone calls or notifications. These coping mechanisms were used to balance work and social life. Subtheme 1.1: Not checking work messages, emails, or attending online meetings outside work hours. The subtheme emphasizes avoiding checking work messages, emails, or participating in online meetings beyond work hours to maintain a healthy WLB. Participants stressed the importance of keeping their professional and personal lives separate by deliberately not engaging in work-related tasks outside of their working time. "I will manage WhatsApp messages by not reading or responding to them outside work hours, even if I see notifications. Instead, I will respond when I start work in the morning. Sometimes, I might not read the message at all and will simply respond later when I'm on duty." (P3) “And when I'm here, I make sure that I do everything to my best. I do my work, and when you need documents, I will provide them because I'm at work. So, when I'm at home, that's my space. I don't want any interference, and I have concluded. That's how I survive.” (P9) “No one is going to say to me, I phoned you at 19h00 and you did not pick up. I am not going to attend any online discussions with my colleagues after work. That must be that during my working hours, right? I won't be online when I'm on leave. It's about my social life at home and nothing else.” (P11) This subtheme highlighted the importance of setting clear boundaries between work and personal life by avoiding work-related tasks outside work hours. Nurse Educators can benefit from adopting this strategy, maintaining a WLB, and protecting their personal space by not checking work messages, emails, or attending online meetings beyond their working time. Establishing clear expectations around work hours and boundaries can lead to improved WLB, reduced burnout, and increased job satisfaction among Nurse Educators. Theme 2: Opting to miss work. The study showed that participants often felt pressured to misrepresent their health by planning to take sick leave when they were extremely exhausted. This suggests that instead of honestly taking the time to rest and recover, Nurse Educators turned to dishonest practices to handle workplace demands, highlighting a significant issue related to the stigma around taking necessary breaks. The verbatim quotes below confirm that: Subtheme 2.1 Absenteeism from work by booking and planning sick leave The subtheme highlights the significant fatigue experienced by Nurse Educators, which often leads them to plan for sick leave as a necessary measure. While seeking medical consultation is common, concerns arise about colleagues having to manage additional workloads during their absence. The accounts also reveal a lack of balance between social life and academic responsibilities, indicating ongoing challenges in maintaining well-being alongside professional demands. "I sometimes feel extremely tired, to the point where I need to plan to take sick leave.” (P4) “I will go to the doctor and consult when I am tired, but my colleagues will suffer, because they must cover up for me.” (P6) “… unless the person is sick, and then they are booked off sick leave. You will be able to have that time for resting, but there isn't that balance between social life and academically”. (P8) This subtheme revealed that Nurse Educators often resorted to booking sick leave as a coping mechanism for extreme exhaustion, rather than being genuinely ill. This practice highlighted the significant fatigue and burnout experienced by Nurse Educators, which led to absenteeism and impacted colleagues' workloads. The findings also suggested a lack of balance between academic responsibilities and social life, underscoring the need for more effective strategies to support Nurse Educators' well-being and manage workplace demands. Theme 3: Utilize support systems The outcomes indicated that the participants shared that to manage their WLB, they sought support by having open discussions with the Head of the Department. These conversations were focused on workload challenges and social well-being, allowing them to address any challenges they faced. Furthermore, colleagues took the initiative to check in on one another regularly, fostering a supportive work environment. Family members also played a crucial role, providing emotional support, which contributed to maintaining their WLB. The following statements from the participants support this: Subtheme 3.1 Managers, colleagues, and family members This subtheme explores the crucial role of managers and colleagues in supporting Nurse Educators’ mental health and coping strategies. It highlights the importance of open communication, access to counselling resources, and emotional support within the workplace to help manage stress and prevent burnout. “…it reached the point where I couldn’t even wake up, and I found it hard to wake up and realize, being in mental health, that I was going towards depression, so I had to make drastic decisions to say How do I cope So I had to speak to my HOD.” (P1) “I don’t think the student counselling is only for students because when you are overwhelmed, you can feel it before people can ask why you are bursting and behaving that way. That is when we must utilize the resources we have.” (P9) “I was so surprised the other day when the lecturer said to me, how are you spiritually? And Dr A is also one of those supportive people that you can go to and talk to. So, there is the Counselling department and then colleagues.” (P12) This subtheme highlighted the importance of support systems in maintaining Nurse Educators' WLB and mental well-being. Participants found value in open discussions with management, particularly the Head of Department, to address workload concerns and stress. Colleagues played a vital role in fostering a supportive work environment through regular check-ins, while family members provided emotional support. Access to counseling resources, both within and outside the institution, was also crucial in helping Nurse Educators manage stress and prevent burnout. Discussion Three themes emerged under the broader category of coping mechanisms used by Nurse Educators to achieve WLB: creating boundaries, opting to miss work, and utilizing support systems. Participants described coping mechanisms such as not taking work home, deliberately ignoring work-related emails and messages while at home, and avoiding online meetings outside official work hours. This aligns with Erasmus et al. ( 11 ), who emphasize that boundary-setting is essential for Nurse Educators to manage their WLB effectively. Nurse Educators suggested that employers can further support this by offering flexible work schedules and social support, which help alleviate heavy workloads and responsibilities. Supporting this view, Bella ( 21 ) highlights boundary creation as a key strategy for achieving WLB, detailing how defining working hours, disengaging from work communication during personal time, and setting realistic workload limits contribute to improved well-being and job satisfaction. In contrast, Poku et al. ( 22 ) found that Nurse Educators report lower WLB compared to clinical nurses. To cope with these challenges, Nurse Educators employ various mechanisms, including boundary-setting, seeking assistance, practicing open communication, and engaging in recreational activities, which together foster a better WLB. Another important coping mechanism revealed by participants was choosing to miss work, whether through absenteeism, requesting medical leave, or planning sick leave. Akhtar et al. ( 23 ) report similar findings, noting that educators may use absenteeism as a protective strategy against unfair treatment by leadership. Their study establishes a significant link between absenteeism and mental health issues, where increased stress and burnout lead to more frequent time off, perpetuating a cycle that undermines WLB. Conversely, Origanti ( 24 ) emphasizes the positive role of coping with strategies such as time management, social support, and mindfulness, underlining the need for organizational support to cultivate a work environment. Participants also identified the utilization of available support—from institutional structures, colleagues, and family members—as a pivotal coping mechanism. Institutional support in the form of flexible scheduling and effective workload management was seen as crucial to maintaining WLB. Bella’s ( 21 ) work further reinforces this by showing how clearly communicated boundaries, disengagement from work during off-hours, and a manageable workload enhance well-being and satisfaction. While Poku et al. ( 22 ) highlights the comparatively lower balance experienced by Nurse Educators, the combination of boundary-setting, seeking support, open communication, and recreational activities remains critical for fostering better WLB. Collectively, these findings underscore the complex interplay of individual strategies and organizational support in managing WLB among Nurse Educators. Recommendations include strengthening flexible work arrangements, promoting clear communication of expectations, and enhancing mental health resources to support Nurse Educators in sustaining their well-being. Abbreviations HOD Head of Department NEI Nursing Education Institution P Participant SMUREC Sefako Makgatho Health Sciences University Research Ethics Committee WLB Work-Life Balance Declarations Consent for publication All participants provided written informed consent for publication of their anonymized quotes. Institutional consent for the publication of this study was also obtained. Ethical approval and consent to participate Ethical clearance was granted by the Sefako Makgatho Health Sciences University Research Ethics Committee (SMUREC/H/249/2023:PG). Subsequent permission was obtained from the National Health Research Database (GP202208010) and the relevant Nursing Education Institution. This study was conducted in accordance with the ethical principles of the Declaration of Helsinki, as adopted by the World Medical Association. All participants provided written informed consent before participation, and no coercion was involved. Competing Interest There is no competing interest. Funding Information This research was carried out without any external financial support from public, commercial, or nonprofit sources. Author Contribution L.M. conceptualized and carried out the study and prepared the initial manuscript draft. R.F.M. provided supervisory guidance and contributed to drafting the manuscript. T.N.R. also supervised the study and was involved in drafting and revising the manuscript. Acknowledgements The authors sincerely thank the Nurse Educators who took part in this study. Appreciation is also extended to Sefako Makgatho Health Sciences University and the Gauteng Department of Health for their invaluable support and for granting permission to undertake this research. Data Availability The data supporting the findings of this study are available from the corresponding author, L.M., upon reasonable request. (“How to Write a Data Availability Statement”) References Salifu DA, Heymans Y, Christmals CD. Facilitating the Development of Clinical Competence in a Low-Resource Setting: Perceptions and Challenges of Nurse Educators. Nurse Media J Nurs. 2022;12(1). Singh K, Alomari AMA, Sayed HMA, Mannethodi K, Kunjavara J, Joy GV, et al. Barriers and solutions to the gap between theory and practice in nursing services: A systematic review of qualitative evidence. 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Int J Multidisciplinary Res Arts Sci Technol. 2023;1(3):24–30. Poku CA, Bayuo J, Mensah E, Bam V. Quality of work-life and coping strategies of Nurse Educators and clinicians in COVID‐19: A cross‐sectional study. Nurs Open. 2023;10(7):4336–45. Akhtar MW, Huo C, Syed F, Safdar MA, Rasool A, Husnain M, et al. Carrot and stick approach: the exploitative leadership and absenteeism in education sector. Front Psychol. 2022;13:890064. Origanti S. Exploring Coping Mechanisms: A Study on Stress Management Techniques for Working Women. Indian Sci J Res Eng Manage. 2024;08(07):1–13. Additional Declarations No competing interests reported. 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10:23:45","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":674032,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7729452/v1/7011badc-686f-4c44-b017-63b0f0130e27.pdf"},{"id":95529291,"identity":"458de560-62a8-43d4-a876-f3f83f2414b1","added_by":"auto","created_at":"2025-11-10 10:16:57","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":17139,"visible":true,"origin":"","legend":"","description":"","filename":"InterviewguideBMC.docx","url":"https://assets-eu.researchsquare.com/files/rs-7729452/v1/480e2ff71d76932a65712b98.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Exploring the coping mechanisms of Nurse Educators towards Work-Life Balance","fulltext":[{"header":"Background","content":"\u003cp\u003eThe global healthcare environment relies heavily on competent Nurse Educators (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). These professionals occupy a critical and demanding role, tasked with bridging theoretical knowledge and clinical practice while navigating the inherent pressures of academic life (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). This complex interplay of responsibilities frequently blurs the boundaries between professional and personal domains, placing Nurse Educators at a high risk for chronic stress, burnout, and attrition (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). Understanding the strategies they employ to manage these pressures is therefore an academic exercise, a crucial imperative for promoting Nurse Educator well-being and ensuring the long-term sustainability of the nursing workforce (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). This study aims to explore the coping mechanisms and support systems utilized by Nurse Educators to achieve work-life balance (WLB) within a Nursing Education Institution (NEI) in Gauteng, South Africa.\u003c/p\u003e\u003cp\u003eNurse Educators find themselves at the crossroads of two intense fields: healthcare and academia (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). Their responsibilities extend beyond lecturing to include designing curricula, supervising clinical practice, conducting research, and managing administrative tasks—all often with limited resources and growing student numbers (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). Managing these varied roles can create significant conflicts between work and personal life, contributing to emotional exhaustion, depersonalization, and a decline in personal achievement—key components of burnout (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThe impact of this imbalance goes beyond individual educators. Burnout has been linked to reduced job satisfaction, lower teaching quality, and increased intentions to leave among health sciences faculty, which in turn intensifies workloads for remaining staff, creating a harmful cycle (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). This highlights the urgent need to prioritize Nurse Educators' WLB as an ethical responsibility and a strategic approach to maintain the quality and stability of nursing education.\u003c/p\u003e\u003cp\u003eWhile the problem of WLB is widely acknowledged, the lived experiences of Nurse Educators, particularly in the Global South, remain under-researched. Much of the existing literature focuses on clinical nurses or academics in other disciplines. However, the unique context of nursing education—with its dual commitment to theoretical rigor and practical skill development—demands a focused investigation (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Understanding the proactive and reactive coping mechanisms that Nurse Educators themselves employ is essential for developing targeted support systems.\u003c/p\u003e\u003cp\u003ePreliminary evidence suggests that strategies may range from individual-level efforts, such as deliberate boundary-setting between work and home life, to seeking organized institutional support (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). This study aims to fill this gap by providing the coping mechanisms Nurse Educators use to navigate their work-life challenges, thereby offering evidence-based insights for institutional policy and fostering a supportive professional environment.\u003c/p\u003e\n\u003ch3\u003eTheoretical framework\u003c/h3\u003e\n\u003cp\u003eThis study is grounded in Spillover Theory (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e), which provides insight into how work and personal life influence each other. For Nurse Educators, coping mechanisms are essential to managing the Spillover effects, particularly when academic duties and administrative responsibilities intrude on family time, causing negative Spillover (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). Positive Spillover occurs when energy and satisfaction gained from work enhance personal life, supporting mental health and overall well-being (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Employing strategies such as setting boundaries, seeking institutional support, and practicing mindfulness can promote positive Spillover, improving job satisfaction and personal fulfillment (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). NEIs must implement policies that clearly separate work and personal time and provide access to mental health resources, reducing negative Spillover and fostering a WLB (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). Aligning institutional policies with Spillover Theory principles enhances the capacity of Nurse Educators to manage their roles effectively, benefiting both their well-being and the wider healthcare education system (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e).\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eThis study utilized a qualitative, descriptive approach to explore the under-researched coping mechanisms and support systems for WLB among Nurse Educators in Gauteng province. This methodology was chosen for its ability to capture detailed accounts of lived experiences in natural settings, offering a deeper understanding of the real-world strategies employed by this population (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). This study adopted a qualitative design, conducted within a specific NEI in Gauteng province. This approach was ideal for gathering rich, in-depth data on WLB strategies within the real-world environment where they are employed (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). By focusing on a single, government-funded NEI, the study could explore the unique institutional factors that influence the support systems and coping mechanisms available to Nurse Educators.\u003c/p\u003e\u003ch3\u003ePopulation and Sampling\u003c/h3\u003e\u003cp\u003eThe study population included all Nurse Educators at the selected NEI in Gauteng. To ensure participants had relevant experiences to share regarding WLB coping mechanisms, specific criteria were applied. Participants were required to have at least six months of teaching experience at a campus offering nursing programmes longer than six months. Those involved solely in curriculum development or who were unavailable were excluded. A non-probability purposive sampling technique was used to select participants who were knowledgeable and experienced in navigating the challenges of WLB as Nurse Educators. The final sample size was 16 participants, determined by the principle of data saturation (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). Saturation, the point where no new themes emerged, was observed after the 13th interview. Three additional interviews were conducted to confirm this, ensuring a comprehensive and rigorous exploration of the coping mechanisms and support systems.\u003c/p\u003e\u003ch3\u003eData Collection\u003c/h3\u003e\u003cp\u003eData were collected through face-to-face, semi-structured interviews using an interview guide with open-ended questions. The questions were developed by the researchers. This method was chosen to facilitate detailed discussions and allow for probing, enabling participants to elaborate deeply on their personal coping mechanisms and the support systems they utilize (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). Following ethical approval, participants were recruited and provided with written informed consent, which included permission for audio recording. Interviews, conducted in English in private settings for 30–45 minutes, focused explicitly on exploring the Nurse Educators' experiences with WLB, the coping mechanisms they employ to manage it, and institutional support.\u003c/p\u003e\u003ch2\u003eData Analysis\u003c/h2\u003e\u003cp\u003eThe data were analyzed using Braun and Clarke's thematic analysis (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e), a method well-suited for identifying, analyzing, and reporting patterns (themes) related to coping mechanisms and support structures. The process began with verbatim transcription and immersion in the data. Through open coding, the researcher identified initial patterns related to how Nurse Educators manage WLB. To ensure the reliability of the themes related to mechanisms and support systems, an independent coder analyzed the data separately. The researcher and coder then collaboratively discussed and refined the codes until a consensus was reached on the final thematic structure. This rigorous process resulted in the identification of three themes, each with three sub-themes, that comprehensively describe the coping mechanisms and support systems for WLB among the Nurse Educators.\u003c/p\u003e\u003ch3\u003eTrustworthiness\u003c/h3\u003e\u003cp\u003eThe trustworthiness of this study, which is essential when exploring personal narratives about coping mechanisms and support systems, was rigorously established using Polit and Beck's framework (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). Credibility, ensuring the accurate identification of genuine strategies and support structures, was built through prolonged engagement with the field, peer review of emerging themes, and triangulation of data sources. Ongoing guidance from experienced qualitative researchers further ensured the findings authentically represented the participants' experiences. Transferability was supported by providing a thick, detailed description of the research context, participant group, and identified coping mechanisms, enabling readers and other researchers to assess the applicability of the findings to similar NEIs and populations. Dependability was achieved by maintaining a clear audit trail of all research decisions and employing a pre-tested, consistent interview guide focused on WLB coping mechanisms, ensuring the research process was logical, traceable, and potentially replicable. Confirmability, safeguarding that findings were rooted in the data provided by the Nurse Educators rather than researcher bias, was strengthened through independent coding. An independent coder analyzed the transcripts, followed by a consensus discussion to align themes and sub-themes related to support systems, as recommended by Gray and Grove (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). This process verifies that the reported mechanisms genuinely derive from participant experiences. Authenticity was demonstrated by faithfully presenting the participants’ voices through verbatim quotes, illustrating their personal coping mechanisms and views on institutional support, thereby ensuring a fair and balanced representation of their lived experiences.\u003c/p\u003e\u003ch2\u003eEthical Considerations\u003c/h2\u003e\u003cp\u003eThe study was guided by core ethical principles to protect participants who shared sensitive information about their professional and personal lives. Respect for human dignity was maintained by ensuring participation was entirely voluntary, with all Nurse Educators providing written informed consent after receiving full disclosure about the study's purpose. Beneficence was prioritized by minimizing potential discomfort through confidentiality and conducting interviews in a safe and private environment. Justice was upheld by rigorously protecting participants’ privacy through anonymity and confidentiality, with all data de-identified using coded pseudonyms. Scientific integrity was ensured by recording, analyzing, and reporting data honestly to represent the support systems and coping strategies discussed accurately.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThe findings revealed that Nurse Educators employ a range of distinct yet interconnected coping mechanisms to achieve WLB. These approaches were characterized by efforts to separate professional and personal domains, strategic disengagement, and active seeking of support. The demographic data for the study participants are presented in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e below.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eDemographic data\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eExperience\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eExperience\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eExperience\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eExperience\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eExperience\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e11 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e11 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e11 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e11 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e11 years\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e8 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e8 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e8 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e8 years\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e11 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e11 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e11 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e11 years\u003c/p\u003e\u003c/td\u003e\u003ctd 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align=\"left\" colname=\"c5\"\u003e\u003cp\u003e16 years\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e4 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e4 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e4 years\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e11 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e11 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e11 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e11 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e11 years\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e18 months\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e18 months\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e18 months\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e18 months\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e18 months\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e8 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e8 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e8 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e8 years\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e16 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e16 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e16 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e16 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e16 years\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e8 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e8 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e8 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e8 years\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e7 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e7 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e7 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e7 years\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e18 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e18 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e18 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e18 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e18 years\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e18 months\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e18 months\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e18 months\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e18 months\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e18 months\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eBased on the provided Table \u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e of demographic data, the study's findings on WLB coping mechanisms are derived from a cohort of 16 predominantly female (93.75%), highly experienced, and mature Nurse Educators (average age\u0026thinsp;~\u0026thinsp;53 years), all of whom hold specialized academic qualifications, suggesting that the identified strategies reflect well-developed, personal approaches honed over time by seasoned professionals deeply familiar with institutional demands, though the insights may be less representative of the challenges faced by younger, early-career, or male educators.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eThemes and subthemes\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"2\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTheme\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSubtheme\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1. Creating boundaries\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.1 Not checking work messages, emails, or attending online meetings outside work hours.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2. Opting to miss work\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2.1 Absenteeism from work by booking and planning sick leave\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e3. Utilization support systems\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3.1 Managers, colleagues, and family members\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e highlights three main themes and subthemes from the findings related to coping mechanisms: creating boundaries, being compelled to miss work, and utilizing institutional support. Nurse Educators play a vital role in shaping the future of nursing by teaching their students essential knowledge and skills. However, participants faced challenges that led to an imbalanced work-life outlook due to the demanding nature of their roles. This situation contributed significantly to feelings of stress and burnout. In response, participants developed and employed specific coping mechanisms to manage their WLB.\u003c/p\u003e\u003cp\u003e\u003cb\u003eTheme 1: Creating boundaries.\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe sub-theme showed that participants learned not to take work home and to do their best to finish their duties during work hours. Some participants would ignore WhatsApp messages from management while at home and avoid online meetings. Additionally, some would not respond to phone calls or notifications. These coping mechanisms were used to balance work and social life.\u003c/p\u003e\u003cp\u003e\u003cb\u003eSubtheme 1.1: Not checking work messages, emails, or attending online meetings outside work hours.\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe subtheme emphasizes avoiding checking work messages, emails, or participating in online meetings beyond work hours to maintain a healthy WLB. Participants stressed the importance of keeping their professional and personal lives separate by deliberately not engaging in work-related tasks outside of their working time.\u003c/p\u003e\u003cp\u003e\u003cem\u003e\"I will manage WhatsApp messages by not reading or responding to them outside work hours, even if I see notifications. Instead, I will respond when I start work in the morning. Sometimes, I might not read the message at all and will simply respond later when I'm on duty.\"\u003c/em\u003e (P3)\u003c/p\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;And when I'm here, I make sure that I do everything to my best. I do my work, and when you need documents, I will provide them because I'm at work. So, when I'm at home, that's my space. I don't want any interference, and I have concluded. That's how I survive.\u0026rdquo;\u003c/em\u003e (P9)\u003c/p\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;No one is going to say to me, I phoned you at 19h00 and you did not pick up. I am not going to attend any online discussions with my colleagues after work. That must be that during my working hours, right? I won't be online when I'm on leave. It's about my social life at home and nothing else.\u0026rdquo;\u003c/em\u003e (P11)\u003c/p\u003e\u003cp\u003eThis subtheme highlighted the importance of setting clear boundaries between work and personal life by avoiding work-related tasks outside work hours. Nurse Educators can benefit from adopting this strategy, maintaining a WLB, and protecting their personal space by not checking work messages, emails, or attending online meetings beyond their working time. Establishing clear expectations around work hours and boundaries can lead to improved WLB, reduced burnout, and increased job satisfaction among Nurse Educators.\u003c/p\u003e\u003cp\u003e\u003cb\u003eTheme 2: Opting to miss work.\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe study showed that participants often felt pressured to misrepresent their health by planning to take sick leave when they were extremely exhausted. This suggests that instead of honestly taking the time to rest and recover, Nurse Educators turned to dishonest practices to handle workplace demands, highlighting a significant issue related to the stigma around taking necessary breaks. The verbatim quotes below confirm that:\u003c/p\u003e\n\u003ch3\u003eSubtheme 2.1 Absenteeism from work by booking and planning sick leave\u003c/h3\u003e\n\u003cp\u003eThe subtheme highlights the significant fatigue experienced by Nurse Educators, which often leads them to plan for sick leave as a necessary measure. While seeking medical consultation is common, concerns arise about colleagues having to manage additional workloads during their absence. The accounts also reveal a lack of balance between social life and academic responsibilities, indicating ongoing challenges in maintaining well-being alongside professional demands.\u003c/p\u003e\u003cp\u003e\u003cem\u003e\"I sometimes feel extremely tired, to the point where I need to plan to take sick leave.\u0026rdquo;\u003c/em\u003e (P4)\u003c/p\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;I will go to the doctor and consult when I am tired, but my colleagues will suffer, because they must cover up for me.\u0026rdquo;\u003c/em\u003e (P6)\u003c/p\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;\u0026hellip; unless the person is sick, and then they are booked off sick leave. You will be able to have that time for resting, but there isn't that balance between social life and academically\u0026rdquo;.\u003c/em\u003e (P8)\u003c/p\u003e\u003cp\u003eThis subtheme revealed that Nurse Educators often resorted to booking sick leave as a coping mechanism for extreme exhaustion, rather than being genuinely ill. This practice highlighted the significant fatigue and burnout experienced by Nurse Educators, which led to absenteeism and impacted colleagues' workloads. The findings also suggested a lack of balance between academic responsibilities and social life, underscoring the need for more effective strategies to support Nurse Educators' well-being and manage workplace demands.\u003c/p\u003e\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003eTheme 3: Utilize support systems\u003c/h2\u003e\u003cp\u003eThe outcomes indicated that the participants shared that to manage their WLB, they sought support by having open discussions with the Head of the Department. These conversations were focused on workload challenges and social well-being, allowing them to address any challenges they faced. Furthermore, colleagues took the initiative to check in on one another regularly, fostering a supportive work environment. Family members also played a crucial role, providing emotional support, which contributed to maintaining their WLB. The following statements from the participants support this:\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003eSubtheme 3.1 Managers, colleagues, and family members\u003c/h2\u003e\u003cp\u003eThis subtheme explores the crucial role of managers and colleagues in supporting Nurse Educators\u0026rsquo; mental health and coping strategies. It highlights the importance of open communication, access to counselling resources, and emotional support within the workplace to help manage stress and prevent burnout.\u003c/p\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;\u0026hellip;it reached the point where I couldn\u0026rsquo;t even wake up, and I found it hard to wake up and realize, being in mental health, that I was going towards depression, so I had to make drastic decisions to say How do I cope So I had to speak to my HOD.\u0026rdquo;\u003c/em\u003e (P1)\u003c/p\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;I don\u0026rsquo;t think the student counselling is only for students because when you are overwhelmed, you can feel it before people can ask why you are bursting and behaving that way. That is when we must utilize the resources we have.\u0026rdquo;\u003c/em\u003e (P9)\u003c/p\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;I was so surprised the other day when the lecturer said to me, how are you spiritually? And Dr A is also one of those supportive people that you can go to and talk to. So, there is the Counselling department and then colleagues.\u0026rdquo;\u003c/em\u003e (P12)\u003c/p\u003e\u003cp\u003eThis subtheme highlighted the importance of support systems in maintaining Nurse Educators' WLB and mental well-being. Participants found value in open discussions with management, particularly the Head of Department, to address workload concerns and stress. Colleagues played a vital role in fostering a supportive work environment through regular check-ins, while family members provided emotional support. Access to counseling resources, both within and outside the institution, was also crucial in helping Nurse Educators manage stress and prevent burnout.\u003c/p\u003e\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThree themes emerged under the broader category of coping mechanisms used by Nurse Educators to achieve WLB: creating boundaries, opting to miss work, and utilizing support systems. Participants described coping mechanisms such as not taking work home, deliberately ignoring work-related emails and messages while at home, and avoiding online meetings outside official work hours. This aligns with Erasmus et al. (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e), who emphasize that boundary-setting is essential for Nurse Educators to manage their WLB effectively. Nurse Educators suggested that employers can further support this by offering flexible work schedules and social support, which help alleviate heavy workloads and responsibilities.\u003c/p\u003e\u003cp\u003eSupporting this view, Bella (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e) highlights boundary creation as a key strategy for achieving WLB, detailing how defining working hours, disengaging from work communication during personal time, and setting realistic workload limits contribute to improved well-being and job satisfaction. In contrast, Poku et al. (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e) found that Nurse Educators report lower WLB compared to clinical nurses. To cope with these challenges, Nurse Educators employ various mechanisms, including boundary-setting, seeking assistance, practicing open communication, and engaging in recreational activities, which together foster a better WLB.\u003c/p\u003e\u003cp\u003eAnother important coping mechanism revealed by participants was choosing to miss work, whether through absenteeism, requesting medical leave, or planning sick leave. Akhtar et al. (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e) report similar findings, noting that educators may use absenteeism as a protective strategy against unfair treatment by leadership. Their study establishes a significant link between absenteeism and mental health issues, where increased stress and burnout lead to more frequent time off, perpetuating a cycle that undermines WLB. Conversely, Origanti (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e) emphasizes the positive role of coping with strategies such as time management, social support, and mindfulness, underlining the need for organizational support to cultivate a work environment.\u003c/p\u003e\u003cp\u003eParticipants also identified the utilization of available support\u0026mdash;from institutional structures, colleagues, and family members\u0026mdash;as a pivotal coping mechanism. Institutional support in the form of flexible scheduling and effective workload management was seen as crucial to maintaining WLB. Bella\u0026rsquo;s (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e) work further reinforces this by showing how clearly communicated boundaries, disengagement from work during off-hours, and a manageable workload enhance well-being and satisfaction. While Poku et al. (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e) highlights the comparatively lower balance experienced by Nurse Educators, the combination of boundary-setting, seeking support, open communication, and recreational activities remains critical for fostering better WLB.\u003c/p\u003e\u003cp\u003eCollectively, these findings underscore the complex interplay of individual strategies and organizational support in managing WLB among Nurse Educators. Recommendations include strengthening flexible work arrangements, promoting clear communication of expectations, and enhancing mental health resources to support Nurse Educators in sustaining their well-being.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003e\u003cb\u003eHOD\u003c/b\u003e\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eHead of Department\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003e\u003cb\u003eNEI\u003c/b\u003e\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eNursing Education Institution\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003e\u003cb\u003eP\u003c/b\u003e\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eParticipant\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003e\u003cb\u003eSMUREC\u003c/b\u003e\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eSefako Makgatho Health Sciences University Research Ethics Committee\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003e\u003cb\u003eWLB\u003c/b\u003e\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eWork-Life Balance\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003ch2\u003eConsent for publication\u003c/h2\u003e\u003cp\u003eAll participants provided written informed consent for publication of their anonymized quotes. Institutional consent for the publication of this study was also obtained.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eEthical approval and consent to participate\u003c/strong\u003e\u003cp\u003eEthical clearance was granted by the Sefako Makgatho Health Sciences University Research Ethics Committee (SMUREC/H/249/2023:PG). Subsequent permission was obtained from the National Health Research Database (GP202208010) and the relevant Nursing Education Institution. This study was conducted in accordance with the ethical principles of the Declaration of Helsinki, as adopted by the World Medical Association. All participants provided written informed consent before participation, and no coercion was involved.\u003c/p\u003e\u003c/p\u003e\u003ch2\u003eCompeting Interest\u003c/h2\u003e\u003cp\u003eThere is no competing interest.\u003c/p\u003e\u003c/p\u003e\u003ch2\u003eFunding Information\u003c/h2\u003e\u003cp\u003eThis research was carried out without any external financial support from public, commercial, or nonprofit sources.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eL.M. conceptualized and carried out the study and prepared the initial manuscript draft. R.F.M. provided supervisory guidance and contributed to drafting the manuscript. T.N.R. also supervised the study and was involved in drafting and revising the manuscript.\u003c/p\u003e\u003ch2\u003eAcknowledgements\u003c/h2\u003e\u003cp\u003eThe authors sincerely thank the Nurse Educators who took part in this study. Appreciation is also extended to Sefako Makgatho Health Sciences University and the Gauteng Department of Health for their invaluable support and for granting permission to undertake this research.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe data supporting the findings of this study are available from the corresponding author, L.M., upon reasonable request. (\u0026ldquo;How to Write a Data Availability Statement\u0026rdquo;)\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eSalifu DA, Heymans Y, Christmals CD. Facilitating the Development of Clinical Competence in a Low-Resource Setting: Perceptions and Challenges of Nurse Educators. Nurse Media J Nurs. 2022;12(1).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSingh K, Alomari AMA, Sayed HMA, Mannethodi K, Kunjavara J, Joy GV, et al. Barriers and solutions to the gap between theory and practice in nursing services: A systematic review of qualitative evidence. Nurs Forum. 2024;2024(1):7522900.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMathebula L, Mathevula RF, Ramalepa TN. A scoping review of the factors affecting work\u0026ndash;life balance among Nurse Educators. Health SA Gesondheid. 2025;30:2910.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHammoudi Halat D, Soltani A, Dalli R, Alsarraj L, Malki A. Understanding and fostering mental health and well-being among university faculty: A narrative review. J Clin Med. 2023;12(13):4425.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBoamah SA, Hamadi HY, Havaei F, Smith H, Webb F. Striking a balance between work and play: The effects of work\u0026ndash;life interference and burnout on faculty turnover intentions and career satisfaction. Int J Environ Res Public Health. 2022;19(2):809.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKim Y, Lee E. The relationship between role conflict, emotional labor, and burnout among Nurse Educators. J Prof Nurs. 2022;38:26\u0026ndash;32.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eJohnson LM, Smith PD, Chen A. Faculty burnout and turnover intention in health sciences education: A meta-analysis. J Allied Health. 2023;52(1):e12\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eDlamini CP, Shumba CS. The unique context of nursing education in the Global South: A call for focused investigation. J Nurs Educ Pract. 2024;14(3):112\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003ePeters MD, Marnie C, Tricco AC, Pollock D, Munn Z, Alexander L, et al. Updated methodological guidance for the conduct of scoping reviews. JBI Evid Synth. 2020;18(10):2119\u0026ndash;26.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eRudaz M, Johnston D. Spillover Theory in occupational health psychology: A review of applications and future research directions. Occup Health Sci. 2024;8(1):75\u0026ndash;100.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eErasmus S, Downing C, Ntshingila N. Work-life integration among Nurse Educators: A meta-synthesis. Front Glob Womens Health. 2024;5:1287484.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSirgy MJ, Lee DJ, Wu J. Positive and negative spillover in work-life balance: A psychological and economic perspective. J Happiness Stud. 2020;21(6):2033\u0026ndash;54.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eFriganović A, Selhofer M, Wang L. Mindfulness and well-being in healthcare professionals: A systematic review. J Clin Nurs. 2023;32(15\u0026ndash;16):4567\u0026ndash;84.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eDepartment of Public Service and Administration. Mental health policies in South African public institutions. Pretoria: Government Printing Works; 2023.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKowalski MO, Haas S, Yoder LH. Applying spillover theory to develop supportive academic environments for nurse faculty. Nurs Outlook. 2024;72(1):101989.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eGray JR, Grove SK. Understanding nursing research: Building an evidence-based practice. 8th ed. Elsevier; 2021.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCreswell JW. Qualitative inquiry and research design: Choosing among five approaches. 5th ed. SAGE; 2022.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003ePascual J, Wallbank S. Analysing Workflows and Improving Communication across Departments: A Quick and Simple Project Using Rapid Contextual Design. Serials Librarian. 2021;80(1\u0026ndash;4):11\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003ePolit DF, Beck CT. Nursing Research: Generating and Assessing Evidence for Nursing Practice. 11th ed. Philadelphia: Wolters Kluwer; 2021.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBraun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77\u0026ndash;101.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBella KMJ. Creating boundaries to maintain a healthy work-life balance. Int J Multidisciplinary Res Arts Sci Technol. 2023;1(3):24\u0026ndash;30.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003ePoku CA, Bayuo J, Mensah E, Bam V. Quality of work-life and coping strategies of Nurse Educators and clinicians in COVID‐19: A cross‐sectional study. Nurs Open. 2023;10(7):4336\u0026ndash;45.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAkhtar MW, Huo C, Syed F, Safdar MA, Rasool A, Husnain M, et al. Carrot and stick approach: the exploitative leadership and absenteeism in education sector. Front Psychol. 2022;13:890064.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eOriganti S. Exploring Coping Mechanisms: A Study on Stress Management Techniques for Working Women. Indian Sci J Res Eng Manage. 2024;08(07):1\u0026ndash;13.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Coping Mechanisms, Work-Life Balance, Nurse Educators","lastPublishedDoi":"10.21203/rs.3.rs-7729452/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7729452/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cb\u003eBackground\u003c/b\u003e\u003c/p\u003e\u003cp\u003eNurse Educators face significant challenges in balancing demanding work commitments with their personal lives, which can lead to stress and burnout. Understanding their coping mechanisms is crucial for promoting work-life balance, enhancing job satisfaction, and ensuring sustainable workforce retention.\u003c/p\u003e\u003cp\u003e\u003cb\u003eMethods\u003c/b\u003e\u003c/p\u003e\u003cp\u003eA qualitative, exploratory design was used. The aim was to explore coping mechanisms for work-life balance. Semi-structured interviews were conducted with 16 Nurse Educators. The educators were from the Nursing Education Institution in Gauteng. The data were interpreted using thematic analysis.\u003c/p\u003e\u003cp\u003e\u003cb\u003eResults\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThree primary themes emerged: 1) Creating Boundaries: Participants consciously separated work from personal life by not taking work home, ignoring after-hours communications, and avoiding non-urgent online meetings. 2) Opting to Miss Work: Nurse Educators used absenteeism, including planned and unplanned sick leave, as a strategy to manage exhaustion and restore balance. 3) Utilizing Support Systems: Nurse Educators sought support from structures such as Heads of Departments, colleagues, and family members for emotional and practical assistance.\u003c/p\u003e\u003cp\u003e\u003cb\u003eConclusion\u003c/b\u003e\u003c/p\u003e\u003cp\u003eNurse Educators employed boundary-setting, strategic absenteeism, and institutional and familial support to cope with work-life balance pressures. Enhancing institutional support systems and promoting strategies to protect personal time may mitigate burnout and improve educator work-life balance.\u003c/p\u003e","manuscriptTitle":"Exploring the coping mechanisms of Nurse Educators towards Work-Life Balance","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-10 05:24:59","doi":"10.21203/rs.3.rs-7729452/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-02-28T14:47:39+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-02-26T10:52:11+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-02-18T12:39:26+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"56813521725723113645473218427152358107","date":"2026-02-18T07:17:02+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-02-16T17:47:33+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"161923911390047668891673027253555285525","date":"2026-02-16T17:25:48+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"70514596706587747854928769512448457359","date":"2026-02-16T07:52:13+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"44567150660526077542547416909262853522","date":"2026-01-18T23:48:52+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"164570918320665913904559494195953443054","date":"2026-01-17T22:52:35+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-10-30T08:57:18+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-10-03T22:41:23+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-10-01T10:16:19+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-09-30T19:40:43+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Nursing","date":"2025-09-30T18:43:31+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"7613802a-f667-4f95-9b36-17875db81645","owner":[],"postedDate":"November 10th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-03-16T06:08:30+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-10 05:24:59","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7729452","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7729452","identity":"rs-7729452","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}

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