include the measurement of nonpatient-related (nonpatient)
factors.
Measuring NI and NWL is a complex process, and many
nonpatient factors affect nurses’ NI and their experiences of
total NWL. NI measures direct and indirect patient-related
workload and does not include nurses’ unit-related workload
[9]. Measuring NI involves an assessment of the nursing
activities and required level of nursing competence that
patients need [7, 10–12]. NI can be described in terms of four
dimensions: how sick a patient is, the patient’s dependency
on nursing, the nursing process, and the time required for
nursing activities [7].
No common definition of NWL is seen in the literature.
NWL measurement refers to any attempt to assess the total
volume and/or level of nursing work [5]. According to a
review study by Myny et al. [13], the main influencing
variables related toNWL are the patient/family, nursing team,
individual nurse, unit and hospital, and meta-characteristics,
in other words, patient-related nursing activities, unit-related
activities, and other organizational and individual-related
factors. Still, a reliable picture of total NWL necessitates
an assessment of central nonpatient factors that may affect
nurses’ experiences of their total NWL, for example, occupational
stress, emotional exhaustion, intrinsic work motivation,
and job satisfaction, and the personal characteristics
of the individual [14, 15]. Factors related to the surrounding
context and organization also have a clear effect on nurses’
experiences of total NWL, such as physical and mental
stress factors in the work environment, work tasks, the
organization of work, and leadership in relation to personnel
administration and/or culture [16].
Therefore, on the basis of the aforereferenced literature
and for the purposes of this study, totalNWLis defined as the
sum of direct and indirect patient-related nursing activities,
nonpatient nursing activities, and central nonpatient factors:
those personal/nurse-related, contextual, and/or organizational
factors may affect nurses’ experiences of their NWL.