Wu ChunQiao, Sun Qian, Liu Ping, Ni Jianbo, Gu Jianhua
Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Department of Radiology, Qilu Hospital of Shandong University (Qingdao), Qingdao, Shandong, China.
Front Public Health. 2025 Jul 23;13:1644328. doi: 10.3389/fpubh.2025.1644328. eCollection 2025.
Radiology nurses face escalating occupational stressors associated with technological advancements and expanding clinical roles; however, evidence on burnout determinants in this specialized population remains limited. This study investigated the interplay between work stress, effort-reward imbalance (ERI), and burnout among radiology nurses, emphasizing the mediating role of ERI.
This multi-center cross-sectional study enrolled 219 radiology nurses from six tertiary hospitals in China (January-March 2024). Validated instruments were used to assess work stress (Nurse Stressor Scale), ERI (Effort-Reward Imbalance Scale), and burnout (Maslach Burnout Inventory-General Survey). Structural equation modeling (SEM) was used to evaluate the mediation pathways, with covariates adjusted via multivariate logistic regression.
The participants presented elevated stress (59.22 ± 6.45), ERIs (mean ratio = 1.26 ± 0.82; 68.9% with ERI values >1), and near-clinical burnout levels (composite score = 3.17 ± 1.18). Emotional exhaustion (3.55 ± 1.95) was predominant. High stress (OR = 6.57, 95% CI = 3.58-12.04) and ERI (OR = 9.92, 95% CI=4.99-19.75) independently predicted moderate-to-severe burnout (38.8% prevalence). Nurses with prolonged weekly hours (65.85 ± 7.69 vs. 60.38 ± 6.22, < 0.05) and chronic illness over time demonstrated heightened vulnerability. SEM revealed that ERI mediated 47.47% of the total effect of work stress on burnout (indirect effect = 0.047, 95% CI = 0.033-0.064), with distinct pathways through effort-reward disparity (31.31%) and overcommitment (17.17%).
Chronic work stress and perceived effort-reward imbalance synergistically exacerbate burnout risk among radiology nurses, with the ERI mediating nearly half of the impact of stress. Targeted interventions addressing both technical demands and psychosocial inequities-particularly reward systems and workload equity-are urgently needed to mitigate occupational health crises in high-precision health care settings.
放射科护士面临着与技术进步和临床角色扩展相关的日益增加的职业压力源；然而，关于这一特殊人群职业倦怠决定因素的证据仍然有限。本研究调查了放射科护士工作压力、努力-回报失衡（ERI）与职业倦怠之间的相互作用，强调了ERI的中介作用。
这项多中心横断面研究于2024年1月至3月招募了来自中国六家三级医院的219名放射科护士。使用经过验证的工具来评估工作压力（护士压力源量表）、ERI（努力-回报失衡量表）和职业倦怠（马氏职业倦怠量表-一般调查）。采用结构方程模型（SEM）评估中介路径，并通过多变量逻辑回归调整协变量。
参与者表现出较高的压力（59.22±6.45）、ERI（平均比值=1.26±0.82；68.9%的ERI值>1）和接近临床职业倦怠水平（综合得分=3.17±1.18）。情感耗竭（3.55±1.95）最为突出。高压力（OR=6.57，95%CI=3.58-12.04）和ERI（OR=9.92，95%CI=4.99-19.75）独立预测中度至重度职业倦怠（患病率38.8%）。每周工作时间延长（65.85±7.69对vs.60.38±6.22，<0.05）和随着时间推移患有慢性病的护士表现出更高的易感性。SEM显示，ERI介导了工作压力对职业倦怠总效应的47.47%（间接效应=0.047，95%CI=0.033-0.064），通过努力-回报差异（31.31%）和过度投入（17.17%）有不同的路径。
慢性工作压力和感知到的努力-回报失衡协同加剧了放射科护士的职业倦怠风险，ERI介导了压力影响的近一半。迫切需要针对性的干预措施来解决技术需求和社会心理不平等问题，特别是奖励系统和工作量公平性问题，以缓解高精度医疗环境中的职业健康危机。
