Abstract

Background: As the number of Americans living with dementia rises, healthcare delivery systems face increasing pressure to provide dementia-specific services to improve patient and family outcomes. The growing primary care Nurse Practitioner (NP) workforce plays a pivotal role in dementia care; however, many NPs practice in poor environments that lack needed organizational attributes and support to maximize their contributions. We examined the associations between the NP practice environment and key indicators of workforce sustainability—burnout, job satisfaction, and intent to leave.

Participants and Setting: We conducted a national cross-sectional survey of NPs caring for patients with dementia in 2022-2023. A total of 968 NPs across 847 practices across the United States completed the survey.

Methods: The NP practice environment was measured using the Nurse Practitioner Primary Care Organizational Climate Questionnaire (NP-PCOCQ) and its four subscales. Multivariable regression models assessed the relationship between practice environment and NP workforce outcomes.

Results: Overall, 92% of NPs were satisfied with their jobs, 35.8% experienced burnout, and 21.3% reported intent to leave their job in the coming year. All four NP-PCOCQ subscales were significantly associated with NP outcomes. For example, a one-unit increase in Professional Visibility score was associated with 67% lower cumulative odds of higher burnout (cumulative OR = 0.36; p = <0.0001); a one-unit increase in the NP-Administration Relations score was associated with 5.15 times cumulative odds of higher job satisfaction (cumulative OR = 5.15; p = <0.0001), and a one-unit increase in the Independent Practice and Support score was associated with 66% lower odds of intent to leave (OR = 0.34; p = <0.0001).

Conclusions: Favorable practice environments are essential to reducing NP burnout and promoting job satisfaction and retention in dementia care settings. To cultivate and sustain a dementia-capable workforce, healthcare systems must implement strategies that enhance NP practice environments.

Notes

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National Institute on Aging [grant number R01AG069143

Reference list included in attached slide deck.

Description

As the number of people living with dementia increases, healthcare delivery systems face increasing pressure to provide dementia-specific services to improve patient and family outcomes. The growing primary care Nurse Practitioner (NP) workforce plays a pivotal role in dementia care; however, many NPs practice in poor environments that may increase their risk of reporting burnout, job dissatisfaction, and intent to leave jobs.

Author Details

Lusine Poghosyan, PhD; Maura Dougherty, PhD; Kathleen Flandrick, PhD; Miles DeGrazia, MA; Joshua Porat-Dahlerbruch, PhD; Grant Martsolf, PhD; Soo Borson, MD; Tatiana Sadak, PhD; Jianfang Liu, PhD

Sigma Membership

Gamma Epsilon

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Cross-Sectional

Research Approach

Quantitative Research

Keywords:

Workforce, Primary Care, Interprofessional and Interdisciplinary, Nurse Practitioners, Dementia Patients, Work Environment, Job Satisfaction

Conference Name

37th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Toronto, Ontario, Canada

Conference Year

2026

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2026-08-26

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Practice Environment and Job Outcomes Among Nurse Practitioners Caring for Patients with Dementia

Toronto, Ontario, Canada

Background: As the number of Americans living with dementia rises, healthcare delivery systems face increasing pressure to provide dementia-specific services to improve patient and family outcomes. The growing primary care Nurse Practitioner (NP) workforce plays a pivotal role in dementia care; however, many NPs practice in poor environments that lack needed organizational attributes and support to maximize their contributions. We examined the associations between the NP practice environment and key indicators of workforce sustainability—burnout, job satisfaction, and intent to leave.

Participants and Setting: We conducted a national cross-sectional survey of NPs caring for patients with dementia in 2022-2023. A total of 968 NPs across 847 practices across the United States completed the survey.

Methods: The NP practice environment was measured using the Nurse Practitioner Primary Care Organizational Climate Questionnaire (NP-PCOCQ) and its four subscales. Multivariable regression models assessed the relationship between practice environment and NP workforce outcomes.

Results: Overall, 92% of NPs were satisfied with their jobs, 35.8% experienced burnout, and 21.3% reported intent to leave their job in the coming year. All four NP-PCOCQ subscales were significantly associated with NP outcomes. For example, a one-unit increase in Professional Visibility score was associated with 67% lower cumulative odds of higher burnout (cumulative OR = 0.36; p = <0.0001); a one-unit increase in the NP-Administration Relations score was associated with 5.15 times cumulative odds of higher job satisfaction (cumulative OR = 5.15; p = <0.0001), and a one-unit increase in the Independent Practice and Support score was associated with 66% lower odds of intent to leave (OR = 0.34; p = <0.0001).

Conclusions: Favorable practice environments are essential to reducing NP burnout and promoting job satisfaction and retention in dementia care settings. To cultivate and sustain a dementia-capable workforce, healthcare systems must implement strategies that enhance NP practice environments.