Factors Influencing Work-Life Balance and the Challenges on the Mental Health of Nurses in Niger Delta University Teaching Hospital, Okolobiri Bayelsa

: This study assessed the factors influencing the work-life balance of Nurses and the challenges to their mental health in Niger Delta University Teaching Hospital, (NDUTH) Okolobiri, Yenagoa, Bayelsa State, Nigeria. This study adopted a descriptive research design. The study objectives were: to identify the factors influencing work-life balance among nurses in NDUTH; and to assess the challenges of work-life balance on the mental health of nurses in NDUTH. A simple random sampling technique was used to select a total of 96 participants which was used accordingly in the study. Data was collected using self-structured questionnaires which were distributed by the researchers, after which questionnaires were retrieved from participants, and data was recorded. Data were analyzed using SPSS version 25 and analyzed data was presented in frequency, percentages, and tables. The study findings show the following factors were found to be influencing the nurses’ mental health in this setting; Social, health-related issues, nurses’ roles, and managerial factors. However, the majority of the nurses in NDUTH were able to identify the factors influencing on the work-life balance of nurses, and the effects and challenges that work-life imbalance poses on their mental health. Furthermore, the majority of the nurses agreed with the appropriate measures that can be taken to enhance the work-life balance of nurses. Therefore, it was recommended that nurse managers and hospital administrators should focus on improving the quality of nurses’ work life in order to improve their professional commitment, subsequently retain qualified staff nurses and decrease turnover by designing programs to teach staff nurses how to cope with work and life stress.


INTRODUCTION
The balance of personal and professional life is a hot topic that is becoming increasingly worrisome due to the impact on health.This concern is as a result of globalization, the intrusion of new technologies into personal life, the overlap of work and family time, new organizational systems, and changes in the nature of work [1].The burden of a cumulatively work demand is the major and most pressing challenge to the general population's mental health.Increased working hours are having a serious impact on the lifestyle of a large number of workforces, including nurses, and this is likely to be harmful to their mental well-being [2].This issue is especially prevalent in occupations that have increased working hours or schedules [3].As a result of the multiple responsibilities necessary in dealing with the health requirements of patients and the community, the nursing work is quite demanding.The nature of the nursing job necessitates the nurse working in shifts, working overtime, reporting to duty at odd hours, caring for the sick and occasionally the terminally ill [4].Nurses' dedication to their career, as well as the physical and emotional strains of caring for the sick and dying, can lead to nurses neglecting to recognize their own physical and emotional needs [5].Aside from taxing the nurses' physical stamina, being in contact with sick and often terminally ill people has an impact on their psychological health.As a result, the nurses are subjected to psychological dangers that are harmful to their health and well-being.However, several elements have an impact on nurses; these include social issues, health-related factors, nurses' roles, and managerial considerations.The failure to establish a balance between their work life and their personal or family life as connected to the above issues is a demanding undertaking for these professionals, which may contribute to the work-life imbalance that most nurses experience.
Work-life balance (WLB) is essentially a set of individual and structural limitations for balancing work and personal time in accordance with an individual's set of values, objectives, and aspirations [6].Work-life balance is a critical issue in the realm of occupational health and safety.This is due to the fact that reaching an ideal WLB is important for an individual's overall well-being.
Nurses are frequently overstressed and receive much less sleep.With the demanding physical and emotional demands of the job, it's also critical to maintain adequate work-life balance to avoid caregiver fatigue and burnout [4].
Similarly, Buerhaus et al, [7], posit that prolonged working hours in clinical settings for nurses might induce significant depression and hormonal imbalances.Report from the World Health Organization, [2] estimated that 20.7 million nurses were employed in the health care industry in 2013, out of a total of 43.5 million health professionals globally.Nursing jobs, without a doubt, have significant job demands, both physically and psychologically.The physical demands placed on nurses reflect the necessity to operate with limited resources, both in terms of manpower and equipment [8].This might result in a high level of emotional tension that borders on weariness.According to Bragard et al, [9] a large majority of nurses have poor quality of work life.Work-life imbalance causes stress [10].Stress manifests itself as both physically and emotionally, as seen by musculoskeletal problems, pain, anxiety, and sleep difficulties [11].Despite the fact that nurses learn to operate under pressure, frequently with little resources, nurses' job stress is distinct due to workplace demand, whereas stress from lifestyle demand is generally shared by all employees.For instance, the majority of hospital nurses are female.Many nurses, depending on their age, take care of children or aged parents while still providing pay and benefits important to their families' fundamental requirements.Work-related stress has become a major contributor to a wide range of physical health issues, from elevated blood pressure to auto-immune disorders, as well as increasing harm to people's relationships.Additionally, research from the literature suggests that several circumstances have a detrimental impact on the quality of nursing work life.Security, job satisfaction, competence growth, work-life balance, control over work load, nurse leadership styles, lack of autonomy, job performance evaluation, prospects for progression, working environment, low education level, and the work unit are among these issues [12,13,14,].Asawalam et al, [15] discovered that female nurses had a poor work-life balance due to stressful work and long working hours, resulting in tiredness after work and insufficient time for family and leisure activities, as well as poor compensation, in a study conducted in private hospitals in Port-Harcourt metropolis in Rivers State, Nigeria.Nurses are frequently confronted with an increasing demand, prolonged work hours, shift and night duties, inter-professional conflicts with other professionals, emotional stressors from patient relationships, job insecurity, insufficient resources, and a shortage of other nursing staff, uncooperative patients, and difficult nurse-nurse relationships.These concerns have a negative impact on nurses' job performance and productivity, as well as the health facility where they provide services.As a result, the variables of work life that are inappropriate and its problems on the mental health of nurses have a negative impact not only on the nurses' mental health but also on their service delivery.Given the importance and function of nurses in the healthcare system, there is a need to ensure that nurses have an optimal work-life balance that improves their mental health.Stress cannot be avoided, but it may be managed to some extent.A balanced existence may be the single most essential lifestyle adjustment individual can accomplish to enhance their health by keeping stress levels to a low and prioritizing self-care.Furthermore, achieving a balance between work and leisure demands implies that fewer nurses will report stress, resulting in better lifestyles both at home and at work.Balancing work and family life in the nursing profession is critical for achieving a high level of well-being and providing superior service.The reason for this is that patient well-being affects the quality of care.
The current study's objectives are to determine the factors influencing work-life balance among NDUTH nurses and to examine the effects of work-life imbalance on the mental health of Nurses in NDUTH.

III. NURSES WORK LIFE BALANCE
Nurses are one of the health-care system's most diversified and biggest workforces.Nurses' roles in the health-care system are increasing and evolving.Nurses' roles are not restricted to institutional care; they also provide services at many levels of the health care system [20].Nurses are one of the most important foundations of the health-care system, and they employ the greatest number of people in the industry.Nurses have a critical role in reducing mortality, morbidity, and disability, as well as promoting health via healthy lifestyles.They play an important role in preserving health status and attaining the country's health-related goals.Nurses are a significant health workforce from the community to higher levels in the health care delivery system because of the different cadres in the health system.The primary health care workers in the community are nurses, midwives, and public health nurses.Nurses' contributions to the health care system include health promotion, preventive, institutional care, and rehabilitation services.A nurse's employment requires them to work in shifts, either for longer stints with a few breaks or without breaks.They must work with a wide range of clients, including the mentally challenged, criminals, and stressed out individuals.Despite their critical position in today's health-care system, nurses face a number of obstacles which are impeding the advancement of nursing.Furthermore, nurses encounter issues from other health care professionals such as bullying, harassment, constant irrational performance demands, inappropriate or misleading communications, politicking and dispute among staff, and so on, which puts a strain on a nursing professional and can have an impact on family and work life.Evidence by a study conducted by Alhani and Oujiyan [21] shows that 70% of workers were unsatisfied with their work-life balance and hence, experienced significant levels of stress.This is due to an imbalance between their job and personal lives.Furthermore, Eshak et al., [22] observed that the number of workers who spend the majority of their time and energy at work and consequently are unable to fulfill their home tasks is steadily growing.Nonetheless, there is friction between family and career.Also, Hao et al. [23], stated that conflict exist, which comprises both family-work conflict and work-family conflict.That is, familial difficulties have an impact on the quality of life at work and result in a diminished capacity to execute professional obligations, whereas occupational responsibilities do not.As a result, workfamily conflict has a detrimental influence on nurses' health because it reduces workplace productivity, increases family tension, increases stress in the person and family members, increases the incidence of stress-related illnesses, absence from work, and psychosomatic disorders [24].Thus, both job and family life are required and should be rewarding and enjoyable.So, nurses must strike a balance between the demands of their jobs and their personal lives.Without a doubt, this is critical for their general health and well-being.However, a balance between work and family is accomplished when an individual is satisfied with his or her personal and professional life duties.Nurses provide an important contribution to the health-care industry and patient care.Thus, to promote a healthy environment for nurses' work-life in Nigeria, the right players in the health system must address the issue of work-life balance.

IV. FACTORS INFLUENCING ON NURSES' WORK LIFE BALANCE
Nurses need to manage the demands of sick patients as well as the emotional burden of assisting certain patients and their families with end-of-life difficulties, among other things.However, some workplace factors have been discovered that may cause stress and negatively impact nurses' work-life balance.These factors may include, but are not limited to, social, health-related, nursing role, and management issues.Nonetheless, nurses' inconsistent sleeping patterns may have an impact on their personal involvement in families.thus, having inadequate time spent for their family and loved ones might severely effect on their mental health [25,26,27].In addition, there is a clear link between excessive working hours and obesity.Nurses work under pressure and for extended periods of time; as a result, nurses try to compensate for their stressful work environment, drowsiness, and weariness by consuming extra meals and alcoholic beverages [28].As a result, this lifestyle raises the possibilities of obesity and chronic illnesses such as diabetes and hypertension [29,30,31].Furthermore, the position of nurses in the health care system as the major workforce and a backbone of the health system has led to a rise in the amount of emotional discomfort caused by occupational stress.Management factors such as job overload, working conditions, and pressure may also have a negative influence on the health of these nurses.For example, the work shift schedule provides nurses with a limited amount of time to relax between shifts.Because the time between shifts is so short, it may alter brain activity from awake to sleep.Wilkins [32] Support the notion that a lack of sleep caused nurses to lose attention and communicate poorly with clients.This could be the reason some nurses' attitude towards clients are poor.Nurses are essential health-care professionals; in order to offer high-quality patient care, nurses' health and work-life balance must be improved.Job-life imbalance is caused by health-related concerns induced by excessive work stress.As a result, it is critical to take preventive measures.Nurses who maintain a work-life balance are physically, psychologically, and emotionally better, which results in reduced absence due to illness or accident.Nurses' stress coping skills, such as managing these factors of work-life balance directly and so improving organizational performance would proffer help.However, there is a need to develop and foster resilience in nurses in order to lessen the negative effects of stress and thereby boost good outcomes in the health care system in Nigeria.

V. CHALLENGES OF WORK LIFE IMBALANCE ON NURSES' MENTAL HEALTH
There is an increasing awareness of job stress as a source of displeasure among registered nurses in Nigerian hospitals, which has contributed to the country's present challenges of nurse recruitment and retention; however, in certain places in Nigeria, this is not the case [33].Nurse leaders must recognize the factors and difficulties that influence nurses' job satisfaction, with work-life balance being a prominent concern.It is worth noting that when nurses are burned out, they feel unable to connect emotionally with patients.This might manifest as nurses being complacent, indifferent, or distant from their patients' discomfort or requests.Furthermore, they may be difficult to communicate properly or may fail to notice little things that might be harmful.However, these difficulties have a negative influence on nurses' mental health.As a result, it is more probable that the nurses are just overworked and have infinite time to decompress from work-related tensions.As a result, the issues of work-life balance and the stress that comes with it may include mental exhaustion, a decreased motivation, burnout, dissatisfaction, tiredness, detachment, and a loss of passion for nursing [34].Other effects of work-life imbalance on nurses' health include physical illness and emotional distress, which can result to conflict in both professional and personal relationships, a higher risk of cardiovascular illness, musculoskeletal disorders [35]; lower output levels, reduced performance, and truancy [36].According to the American Nurses Association Survey [37the top issue for nursing staff in terms of health and safety in the workplace is the acute or chronic effect of stress.Nursing work circumstances include exposure to suffering and death, interpersonal conflicts, a lack of autonomy and responsibility for decision making, and a lack of definition of the professional position, all of which contribute to a state of chronic stress [38].Overstressed nurses may acquire unfavorable attitudes and sentiments about nursing, patients, and coworkers.The individual's personal reactions to these circumstances might be psychological, with symptoms such as anxiety, annoyance, and despair, or psychosomatic, with headaches, nausea, and sleep issues, with potentially detrimental consequences for patient safety and treatment quality [39].This might be as a result of the changes in organizations.If not control could lead to a higher level of stress for the nurses, the professional and society at large if not tackled.Therefore, since nurses play a significant role in providing healthcare to their patients, work-life balance is an important phenomenon.As a result, emphasizing work-life balance as a crucial aspect in both ensuring optimum health for nurses and adequate delivery of quality health care to Nigerian citizens.As a result, it is critical for nurses to acquire coping strategies for combining their professional and home life in order to limit the danger of emotional strain on their mental health.

VI. MATERIAL AND METHOD
This study was a descriptive survey conducted in Niger Delta University Teaching Hospital Bayelsa State (NDUTH).The total population of this study comprises of 96 nurses randomly selected from 127 nurses in NDUTH.The study involved Two research questions; to identify the factors influencing work life balance among nurses in NDUTH; and to assess the challenges of work life imbalance on the mental health of nurse in NDUTH and the corresponding research questions.A 5-point Likert self-structured questionnaire consisting SA (strongly agree), A (agree), SD (strongly disagree), U(Uncertain) & D(disagree) was used.A reliability index of 0.80 was ensured through the Cronbach alpha statistic.Also, the instrument was validated by experts in this field.A written consent was sought from respective participants before collection of data.Data collection lasted for two (2) weeks.Data was analyzed using a descriptive statistic through a software called SPSS version 25, imputed data was analyzed for socio-demographic characteristics, factors influencing work life balance and challenges of work life imbalance on mental health of nurses.Analyzed data was presented in tables, frequencies and percentages.1 analysis result indicates that 27(28%) of the respondents were between the ages of 20 -29 years, 41(43%) were between the ages of 30 -39 years, 22(23%) were between the ages of 40 -49 years, while only 6(6%) were between the ages of 50 years & above.Also, from the study, 19(19.8%) of the respondents were male while 77(80.2%)were female.Also, in term of marital status, it was observed that, 48(50%) of the respondents are single, 46(47.9%)are married, 0(0%) are divorced and 2(2.1%) are widowed.For religion, the result indicated that, 95(99%) of the respondents are Christians while only 1(1%) is a Muslim.For professional qualification, 18(19%) of the respondents are Registered Nurses, 25(26%) are Registered Nurses with other nursing specialty qualification, 30(31%) are Registered Nurses with BNSc alone while 23(24%) are Registered Nurses with other Nursing specialty qualification including BNSc and 0(0%) do not have any other higher qualification.Lastly, for working experience, 43(44.8%) of the respondents have had 1 -10 years of working experience, 27(28.1%)have had 11 -20 years of working experience, 14 (14.6%)have had 21 -30 years of working experience and 12(12.5%)have had 31 and above years of working experience.SD-Strongly Disagree; D-Disagree; U-Uncertain; A-Agree; SA-Strongly Agree From table 2 above, 70(72.9%) of the respondents agreed that presence of stressors related to family/marital problems can influence nurses' work life balance while 9(9.4%) strongly agreed, 3(3.1%) strongly disagreed, 14(14.6%)disagreed whereas, 0(0%) were uncertain whether presence of stressors influences on the nurses' health or not.Also, 63(65.6%) of the respondents agreed that conflicts with coworkers can influence nurses' work life balance while, 14(14.6%)strongly agreed, 4(4.2%) strongly disagreed, 10(10.4%)disagreed whereas 5(5.2%) were uncertain whether conflicts with colleagues' influences on nurses in this setting.The result also shows that 55(57.3%) of the respondents agreed that superiors' poor leadership can influence nurses' work life balance, while 17(17.7%)strongly agreed, 2(2.1%) strongly disagreed, 17(17.1%)disagreed, whereas, 5(5.2%) were uncertain whether superior's poor leadership can influence nurses' work life balance or not.Also, 53(55.2%) of the respondents agreed that ) of the respondents strongly agreed while, 4(4.2%) strongly disagreed, 6(6.3%) disagreed, whereas, 0(0%) were uncertain whether unappreciated work and underpayment influences nurses' work life balance or not.Furthermore, 52(54.2%) of the respondents strongly agreed that excessive workload as factor influences on WLB of nurses while, 39(40.6%)agreed, 2(2%) strongly disagreed, 3(3.1%) disagreed whereas, 0(0%) are uncertain whether excessive workload influences on WLB of nurses or not.Also, the result shows that 51(53.1%) of the respondents agreed that unfavorable working condition can influence nurses' work life balance, while 42(43.8%)strongly agreed, 0(0%) strongly disagreed or disagreed, whereas,3(3.1%)were uncertain whether unfavorable working condition can influence nurses' work life balance or not.Result from table 3 above, shows that 58(60.4%) of the respondents agreed that mental fatigue can impact on the nurses' mental health, while 24(25%) strongly agreed, and 5(5.2%) strongly disagreed while, 9(9.4%) disagreed, whereas, 0(0%)were uncertain.Also, 50(52.1%) of the respondents agreed that work life imbalance can lead to anxiety and depression and 24(25%) strongly agreed, 5(5.2%) strongly disagreed, while 7(7.3%) disagreed, whereas 10(10.4%)were uncertain whether work life imbalance can lead to anxiety and depression.Moreover, 48(50%) of the respondents agreed that work life imbalance increase mistakes and accidents, while 24(25%) strongly agreed, 12(12.5%)stronglydisagreed, while 5(5.2%)disagreed, whereas 7(7.3%)were uncertain whether it increases mistakes and accidents or not.The result above also shows that 46(47.9%) of the respondents strongly agreed that nurses face the increased level of stress on their mental health, while 26(27.1%)agreed, 5(5.2%) strongly disagreed, while17(17%) disagreed, whereas 2(2.1%) were uncertain whether nurses face the level of stress on their mental health or not.Finally, the above results, shows that 44(45.8%) of the respondents strongly agreed that work related stress can cause job burnout, while 40(41.7%)agreed, 8(8.3%) disagreed, 2(2.1%) strongly disagreed, whereas 2(2.1%) were uncertain whether work related stress can cause job burnout or not.

VIII. DISCUSSION OF FINDINGS
The following factors have been identified as impacting the work-life balance of nurses at NDUTH: pressures connected to family life/marital problems, conflict with coworkers, superiors' poor leadership style, unappreciated work/underpayment, an excessive workload / nursing shortage, and an unfavorable working condition.These findings are consistent with those of Lasebikan & Oyetunde [33] who found that among nurses, the incidence of occupational stress-related burnout is high, and that factors such as excessive workload, emotional stress, unevaluated work and underpayment, poor leadership, conflicts with staff, accepting responsibility, a lack of social support, conflict with other nurses, conflict with physicians, the presence of stressors related to private life, and inadequate clinical care are all factors.Thus, the factors mentioned above were discovered to be responsible for impacting the work-life balance of nurses in this setting.
It was also shown that nurses endure the most stress in the health industry owing to the nature of their employment.This is consistent with a research by Zhang, et al, [24] which found that there is a rise in stress, an increase in the incidence of stress-related illnesses, absence from work, and psychosomatic problems due to the high level of stress among this workforce.Furthermore, the study found that work-life imbalance can cause stress symptoms such as anxiety and depression; this is consistent with a study done Levin [39] stated that an individual's psychological response to the effect of stress may include symptoms such as anxiety, irritation, and depression, or psychosomatic, involving headaches, nausea, and sleep problems, with other potential negative consequences for patient safety.Also shown are the obstacles to mental health, such as mental fatigue and burnout caused by increased stress, job strain, and weariness, which might impact the quality of patient care or increase the occurrence of mistakes and accidents at work and at home.This finding is consistent with the findings of Lasebikan &Oyetunde, [33] who found that the incidence of occupational stressrelated burnout is high among nurses and that burnout syndrome is a major consequence of persistent exposure to work-related stresses.According to Vargas et al, [34] the repercussions of professional burnout include mental fatigue and a lack of motivation.

IX. CONCLUSION
In conclusion, in order to attain work-life balance as a nursing professional, nurses must address the issues they face both at work and at home.This would assist to reduce the existing imbalances.Work-life imbalance has a negative influence on professional life by causing job dissatisfaction and reduced organizational commitment.As a result, the study suggests that nurses allocate their time and make personal efforts to achieve consistency between the two positions.Trainings, re-examination of work-life balance policies, modification and implementation of work-life balance programs in place in line with the needs of nurses by hospitals or managements should be implemented to improve nurses' mental health well-being.This would benefit not just the organization in terms of boosting service quality, but it would also serve to improve the quality of life for nurses in general.

X. CONFLICTS OF INTEREST
The authors declare no conflict of interest.
underpayment can influence nurses' work life balance and 31(32.3%

Table 1 :
Frequency Distribution of Socio-Demographic Characteristics of Participants

Table 2 :
Frequency Distribution on Factors Influencing Nurses' Work Life Balance ISSN:

Table 3 :
Frequency Distribution on the challenges of Work Life Imbalance