Tan Yuanyuan, Zhou Jing, Zhang Hao, Lan Lin, Chen Xiaoli, Yu Xiaomin, Zhong Luying, Zhu Ling, Gao Yongli
Department of Health Management Center, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, China.
Department of Emergency Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China.
Front Public Health. 2025 May 26;13:1580501. doi: 10.3389/fpubh.2025.1580501. eCollection 2025.
Effort-reward imbalance (ERI) is a prevalent issue in the healthcare sector, particularly in the high-intensity, high-risk, and high-stress environment of the emergency department. This results in emergency department nurses bearing heavier workloads, responsibilities, and time commitments compared to their counterparts in other departments. ERI poses significant risks to their physical, psychological, and sleep quality. Therefore, it is essential to explore the mechanisms through which ERI influences the health of emergency department nurses.
The aim of this investigation is to analyze if work-family conflict moderates the mediating influence emotional exhaustion has on the association between ERI and somatic symptoms and sleep disorders.
A cross-sectional study.
The emergency nurses ( = 1,540) were included from 30 tertiary hospitals in 20 provinces or autonomous regions (Northeast, North, East, Central, South, Southwest, and Northwest China) of mainland China between December 26, 2023, and January 18, 2024.
Participants were recruited using stratified cluster sampling, obtaining data through web-based questionnaires. The study investigated the mediating and moderating effects using the macro for SPSS. The mediation effect is tested by the bias correction sample size was set to 5,000.
Considering emotional exhaustion as a mediating variable, the direct predictive influence of ERI on somatic symptoms and sleep disorders continues to be statistically significant ( = 0.271, 0.137, < 0.01). Compared to the high-level work-family conflict group, the positive moderating effect of low-level work-family conflict on the relationship between ERI and emotional exhaustion was more pronounced ( = 0.479, 0.757, < 0.01). The moderated mediation effects of emotional exhaustion on somatic symptoms and sleep disorders are -0.063 (95%CI: -0.077 ~ -0.050) and -0.044 (95%CI: -0.056 ~ -0.033) respectively.
The study findings indicate that ERI was correlated with heightened emotional exhaustion, somatic symptoms, and sleep disorders among emergency department nurses. As a result, interventions should be implemented to improve ERI, alleviate emotional exhaustion among nurses, monitor work-family conflict levels, and mitigate the effects of these factors on nurses' overall well-being.
努力-回报失衡（ERI）是医疗保健部门中普遍存在的问题，尤其是在急诊科高强度、高风险和高压力的环境中。这导致急诊科护士比其他科室的护士承担更重的工作量、责任和时间投入。ERI对他们的身体、心理和睡眠质量构成重大风险。因此，探索ERI影响急诊科护士健康的机制至关重要。
本调查的目的是分析工作-家庭冲突是否会调节情绪耗竭在ERI与躯体症状和睡眠障碍之间关联中的中介作用。
一项横断面研究。
2023年12月26日至2024年1月18日期间，从中国大陆20个省或自治区（东北、华北、华东、华中、华南、西南和西北）的30家三级医院纳入了急诊护士（n = 1540）。
采用分层整群抽样法招募参与者，通过网络问卷获取数据。本研究使用SPSS宏程序来研究中介和调节效应。中介效应通过偏差校正法进行检验，样本量设定为5000。
将情绪耗竭作为中介变量，ERI对躯体症状和睡眠障碍的直接预测影响在统计学上仍然显著（β = 0.271，0.137，p < 0.01）。与高水平工作-家庭冲突组相比，低水平工作-家庭冲突对ERI与情绪耗竭之间关系的正向调节作用更为明显（β = 0.479，0.757，p < 0.01）。情绪耗竭对躯体症状和睡眠障碍的调节中介效应分别为-0.063（95%CI：-0.077 ~ -0.050）和-0.044（95%CI：-0.056 ~ -0.033）。
研究结果表明，ERI与急诊科护士情绪耗竭加剧、躯体症状和睡眠障碍相关。因此，应实施干预措施以改善ERI，减轻护士的情绪耗竭，监测工作-家庭冲突水平，并减轻这些因素对护士整体幸福感的影响。
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