Liu Li, Wu Di, Wang Lulu, Qu Yunting, Wu Hui
Department of Social Medicine, School of Public Health, China Medical University, Shenyang, Liaoning, People's Republic of China.
School of Fundamental Sciences, China Medical University, Shenyang, Liaoning, People's Republic of China.
Risk Manag Healthc Policy. 2020 Jul 27;13:893-901. doi: 10.2147/RMHP.S259339. eCollection 2020.
Fatigue undermines nurses' well-being and work performance worldwide. Work stress is a critical factor that causes nurses' fatigue, but the solutions are not well known. This study aimed to identify the moderated mediation model of fatigue involving effort-reward imbalance (ERI), resilience and perceived organizational support (POS) in Chinese nurses.
In a cross-sectional investigation conducted in Liaoning Province of China, 996 nurses completed the self-administered measurements of fatigue, ERI, resilience and POS. Moderated mediation was tested using the PROCESS procedure. The "pick-a-point" method was adopted to assess conditional effect on fatigue.
The indirect effect of ERI on fatigue through resilience was significant (a×b = 0.119, BCa 95% CI: 0.094 to 0.146), indicating a partial mediation of resilience. POS moderated the association of resilience with fatigue ( = -0.056, = 0.006). The higher the level of POS was, the stronger the resilience-fatigue association became. Thus, the mediating role of resilience in the ERI-fatigue association was gradually increased with the increase of POS level (low POS: 0.073; moderate POS: 0.095; high POS: 0.116).
Resilience could partially mediate the ERI-fatigue association. POS could act as a moderator that enhanced the association of resilience with fatigue. A moderated mediation model of fatigue was demonstrated in Chinese nurses. Managers should establish a balanced social reciprocity, and improve nurses' resilience and POS in order to decrease nurses' fatigue.
疲劳在全球范围内损害护士的身心健康和工作表现。工作压力是导致护士疲劳的关键因素，但解决方案尚不明确。本研究旨在确定中国护士中涉及努力-回报失衡（ERI）、心理韧性和感知组织支持（POS）的疲劳调节中介模型。
在中国辽宁省进行的一项横断面调查中，996名护士完成了关于疲劳、ERI、心理韧性和POS的自填式测量。使用PROCESS程序检验调节中介效应。采用“选点法”评估对疲劳的条件效应。
ERI通过心理韧性对疲劳的间接效应显著（a×b = 0.119，BCa 95% CI：0.094至0.146），表明心理韧性起部分中介作用。POS调节心理韧性与疲劳之间的关联（ = -0.056， = 0.006）。POS水平越高，心理韧性与疲劳之间的关联越强。因此，随着POS水平的升高，心理韧性在ERI-疲劳关联中的中介作用逐渐增强（低POS：0.073；中等POS：0.095；高POS：0.116）。
心理韧性可部分中介ERI-疲劳关联。POS可作为调节变量增强心理韧性与疲劳之间的关联。在中国护士中证实了疲劳的调节中介模型。管理者应建立平衡的社会互惠关系，提高护士的心理韧性和POS，以减轻护士的疲劳。
