Date of Award

January 2020

Document Type


Degree Name

Doctor of Philosophy (PhD)



First Advisor

F. R. Ferraro


Worldwide nursing shortages have led to an increased burden on healthcare systems, and this is especially true in already underserved, remote, and rural areas, where access to healthcare is limited and the loss of highly-skilled nursing professionals is deeply-felt. Professional quality of life (ProQOL) has been studied as a major influence on nurses’ wellbeing, job satisfaction, burnout rates, turnover rates, and quality of care. While certain job-related factors that impact nurses’ ProQOL outcomes have been identified – excessive workload, exposure to trauma, financial strain due to low wages, lack of or over-emotional engagement in the workplace, individual disposition – certain social factors that impact nurses’ ProQOL have been less well-researched, especially from a systems-change perspective. The current study aims to investigate social predictors of ProQOL outcomes in rural nurses using data from a 2019 study (currently in-progress) on nurse intent to stay in their current positions/geographic locations. Confirmatory factor analysis was used to test ProQOL model fitness and covariance-based SEM was used to test proposed hypotheses.