Risk Management and Healthcare Policy (Jul 2020)

Effort-Reward Imbalance, Resilience and Perceived Organizational Support: A Moderated Mediation Model of Fatigue in Chinese Nurses

  • Liu L,
  • Wu D,
  • Wang L,
  • Qu Y,
  • Wu H

Journal volume & issue
Vol. Volume 13
pp. 893 – 901

Abstract

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Li Liu,1 Di Wu,2 Lulu Wang,1 Yunting Qu,1 Hui Wu1 1Department of Social Medicine, School of Public Health, China Medical University, Shenyang, Liaoning, People’s Republic of China; 2School of Fundamental Sciences, China Medical University, Shenyang, Liaoning, People’s Republic of ChinaCorrespondence: Hui WuDepartment of Social Medicine, School of Public Health, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang 110122, People’s Republic of ChinaTel +86 189 0091 0568Email [email protected]: 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.Methods: 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.Results: 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 (β = − 0.056, p = 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).Conclusion: 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.Keywords: fatigue, effort-reward imbalance, resilience, perceived organizational support, nurses

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