The Key Role of Nurse–Patient Mutuality in Shaping Professional Quality of Life Among Nurses: A Bayesian Path Analysis

Aim: To examine the association between nurse–patient mutuality (i.e., a good quality of the relationship between the nurse and the patient) and nurse professional quality of life. Design: A cross- sectional, multi- centre study was conducted across four tertiary hospitals in Italy. Methods: Data collection took place from November 2023 to June 2024, enrolling 517 nurses. Both medical and surgical depart ments, as well as inpatients and outpatients departments were included. Data were collected on nurses caring for patients with chronic illness. Mutuality was measured with the Nurse–Patient Mutuality in Chronic Illness scale, which includes three dimen sions: Developing and Going Beyond, Being a Point of Reference, Deciding and Sharing Care; Professional Quality of Life was measured with the Professional Quality of Life version 5, which includes three dimensions: Compassion Satisfaction, Secondary Traumatic Stress, Burnout. A Bayesian path analysis was employed to evaluate the contribution of mutuality dimensions to the dimensions of professional quality of life. Results: Nurses' sample consisted of 517 participants. The three dimensions of mutuality showed different associations with the three dimensions of professional quality of life. Specifically, Being a Point of Reference, along with Deciding and Sharing Care, was significantly associated with Compassion Satisfaction. The dimensions Developing and Going Beyond and Deciding and Sharing Care were significantly and negatively associated with Secondary Traumatic Stress. Additionally, Deciding and Sharing Care was significantly and negatively associated with Burnout. Conclusions: As all the dimensions of mutuality were significantly associated with different aspects of professional quality of life, future interventions to improve nurses' professional quality of life may also consider nurse–patient mutuality. Implications for the Profession: Nurse–patient mutuality may be a novel area of research to enhance nurses' professional quality of life, with implications for clinical practice and organisational development. Impact: Nurse–patient mutuality is a key indicator of a high- quality relationship, enabling shared goals and shared decision- making. Nurses' professional quality of life is one of the most important factors that influence their intention to leave. Little is known about the association between nurse–patient mutuality and nurses' professional quality of life. Mutuality influences nurses' and patients' outcomes. Understanding mutuality could enhance the professional quality of life for nurses, improving their compassion satisfaction and reducing their burnout.