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

Abstract

Purpose 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.

Effect of Perceived Organizational Support on Fatigue of Chinese Nurses during the COVID-19 Pandemic: Resilience as a Mediator

“…The Chinese version of this scale was developed and verified by Ling et al [35]; it consists of 8 items (e.g., "Your organization cares about your well-being") scored on a five-point scale, range from 1 = strongly disagree to 5 = strongly agree, with higher scores indicating a higher level of nurse's POS. In previous research among different kinds of Chinese clinical groups, the scale has satisfactory reliability and validity all the time [14,34]. For this study, the Cronbach's α was 0.904.…”

“…Following Liu et al [34] research, the Survey of Perceived Organizational Support created by Eisenberger et al [24] was administered to measure nurses' POS. The Chinese version of this scale was developed and verified by Ling et al [35]; it consists of 8 items (e.g., "Your organization cares about your well-being") scored on a five-point scale, range from 1 = strongly disagree to 5 = strongly agree, with higher scores indicating a higher level of nurse's POS.…”

“…The scale consists of 25 items (e.g., "Can handle unpleasant feelings", "Able to adapt to change" and "You can achieve your goals"), and uses a fivepoint ranging scale (1 = not true at all, 5 = true nearly all of the time), with higher scores reflecting greater nurse's resilience. This scale has been widely applied in Chinese studies and has good reliability and validity [14,34,36]. In the research, the CD-RISC also has shown good reliability with Cronbach's α was 0.931.…”

“…The current findings line up with Rísquez et al [41] and Alsharif's [19] results, in which nursing students who showed a higher level of resilience experienced less emotional fatigue, as well as Jin et al [42] research, which found that resilience had a negative correlation with emotional fatigue. A possible explanation for these findings might be that when nurses have a higher level of resilience, they tend to show more emotional stability when faced with adversity in a constantly changing workplace environment [34,43,44]. Accordingly, resilience is a vital resource for alleviating all kinds of fatigue in nurses, whether it be mental, physical, or emotional fatigue.…”

“…Moreover, resilience was found to be a mediator of the relationship between POS and anxious among underground coal miners [33]. Other research indicated that resilience could partially mediate the association of effort-reward imbalance with fatigue in Chinese nurses [34]. However, whether resilience mediates the relationship between POS and fatigue has not been tested among Chinese nurses.…”