Work alienation and quality of life in nurses: A cross-sectional study of serial mediation through emotional exhaustion and job satisfaction

This study examines the impact of work alienation on nurses’ quality of life in Pakistani public-sector hospitals, with a focus on the mediating roles of emotional exhaustion and job satisfaction. Using a cross-sectional design, data were collected from 320 nurses working in public hospitals of Punjab, Pakistan. A structured questionnaire was used to measure work alienation, emotional exhaustion, job satisfaction, and quality of life. Hayes’s PROCESS macro (Model 6) was applied to test the hypothesized serial mediation model. The findings revealed that work alienation significantly increased emotional exhaustion and decreased job satisfaction. Emotional exhaustion negatively influenced both job satisfaction and quality of life, while job satisfaction was positively associated with quality of life. The direct effect of work alienation on quality of life was nonsignificant; however, indirect effects through emotional exhaustion and job satisfaction, including their serial pathway, were significant. These findings highlight the indirect mechanisms through which work alienation shapes quality of life. The study suggests that reducing emotional exhaustion and enhancing job satisfaction are crucial strategies for improving Pakistani nurses’ quality of life.