Impact of effort-reward imbalance, emotional labour, and nurse-patient relationship on physical and mental health of registered nurses in China: a structural equation modeling

Abstract

Abstract Background Currently, the physical and mental health of nursing staff in China is not optimistic and cannot be ignored. Meanwhile, the tense nurse-patient relationship imposes higher demands on the emotional labor of nursing staff. How to maintain a balance between the contributions and rewards of nursing staff, guide them to engage in moderate emotional labor, and improve their physical and mental health has become an important and urgent issue that medical institutions and the entire society need to address. The purpose of this study was to explore the effect of effort-reward imbalance on the physical and mental health of nurses, focusing on the mediating role of emotional labor and nurse-patient relationship, and to provide a basis for formulating strategies and measures to improve the health status of nursing staff. Methods A cross-sectional design was employed.Using convenience sampling methods, 2191 new nurses were surveyed in 7 hospitals in Hubei Province, China, from June to October 2024. Data were collected using demographic characteristics questionnaire, the Short Form-12(SF-12) scale, the Effort-reward imbalance Scale, the Emotional labour Scale for Nurses, while the nurse-patient relationship was assessed using single items. AMOS 26.0 was used for model drawing and mediation path testing, and SPSS 26.0 was used for data analysis. Results The mediation model shows a good fit (χ2/df = 2.747, CFI = 0.981, AGFI = 0.971, IFI = 0.982, GFI = 0.990, TLI = 0.961, and RMSEA = 0.056). In this study, we found emotional labour is a mediating variable between effort-reward imbalance and physical and mental health of nurses (β = 0.009, P = 0.019), nurse-patient relationship is a mediating variable between effort-reward imbalance and physical and mental health of nurses (β = 0.126, P < 0.01) and emotional labour and nurse-patient relationship play a chain mediating role in effort-reward imbalance and physical and mental health (β = 0.011, P = 0. 023). Conclusions The study emphasizes the significance of enhancing the physical and mental health of nurses. Policymakers and hospital administrators should devise policies and strategies that encourage nurses to demonstrate an appropriate level of dedication, balance effort and reward, establish a safe working environment, and improve emotional labor to promote harmonious nurse-patient relationships, thereby improving the physical and mental health of nurses.

Keywords

• Nurse
• Effort-reward imbalance
• Emotional labour
• Nurse-patient relationship
• Health