Research On Emotional Labor And Influencing Factors Of Clinical Nurses

Objectives1.To investigate the status of nurses’ emotional labor,and analyze the influence of social demographic characteristics,psychological contract breach and overqualification on nurses’ emotional labor.2.To explore the effects of overqualification and psychological contract breach on the emotional labor of nurses.3.To explore the emotional labor experience and demands of clinical nurses through qualitative research,and provide reference for managers to take targeted intervention measures.Methods1.A questionnaire survey was conducted on 887 clinical nurses from three tertiary A hospitals in Jiangsu Province from May to June 2022 by convenient sampling method with general data questionnaire,Emotional Labor Scale(ELS),Psychological Contract Scale of Nursing Staff(PCSNS)and Perceived Overqualification Scale(POS).2.SPSS 26.0 was used for data analysis and a normality test was performed on the data.The measurement data conforming to the normal distribution were expressed in x±s,the measurement data conforming to the skewed distribution were expressed in[M(P25,P75)],and the counting data were expressed in frequency and percentage.Independent sample t-test or one-way ANOVA were used to explore the current situation and influencing factors of emotional labor among nurses.Pearson correlation analysis method was used to measure the correlation between psychological contract breach,overqualification,and emotional labor.Multiple stepwise linear regression was used to analyze the influencing factors of emotional labor among nurses.AMOS 26.0 was used to construct a path model between overqualification,psychological contract breach,and nurses’ emotional labor,while the maximum likelihood method(ML)was used to estimate the parameters and the test of mediating effect was corrected by Bootstrap method(5000 repeated samples).3.17 clinical nurses from three tertiary A hospitals in Jiangsu Province were selected as the survey subjects for semi-structured in-depth interviews by objective sampling method from September 2022 to January 2023.The interview data were analyzed,summarized,and extracted using the NVivo 12plus and Colaizzi seven-step methods.Results1.Nurses’ emotional labor score and influencing factors(1)The total score of emotional labor of nurses was(50.50±110.09),the total average score was(3.61±0.72),the average score of each dimension from high to low was deep acting(4.72±0.73),emotional expression requirements(3.33±1.04),and surface acting(3.29±1.00).(2)The results of univariate analysis showed that there were statistically significant differences in the scores of surface acting scores of emotional labor of nurses in terms of job purpose,career orientation and planning(all P<0.05);There were statistically significant differences in the scores of emotional expression requirements of emotional labor of nurses in terms of age,professional title,nursing age,working years of current department,employment relationship,job purpose,career orientation and planning(all P<0.05);There were significant differences in the scores of deep acting of emotional labor of nurses in terms of age,professional title,nursing years,working years of current department,monthly income,employment relationship,job purpose,career orientation and planning(all P<0.05).(3)The results of correlation analysis showed that emotional labor,surface acting,and emotional expression requirements of nurses were positively correlated with psychological contract breach and its various dimensions(r=0.322～0.401,all P<0.01),and positively correlated with overqualification(r=0.337-0.374,all P<0.01);The deep acting of emotional labor was negatively correlated with psychological contract breach and its various dimensions(r=-0.217～-0.236,all P<0.01),and negatively correlated with overqualification(r=-0.139,all P<0.01).(4)The results of multiple linear regression analysis showed that job purpose,career orientation and planning,psychological contract breach,and overqualification explained 20.3%of the variance in surface acting;Working years of current department,psychological contract breach,and overqualification explained 19.8%of the variance in emotional expression requirements;Career orientation and planning,and psychological contract breach explain 8.8%of variation in deep acting.2.The effect of nurses’overqualification and psychological contract breach on emotional laborThe results of the corrected model fit showed that the model fitted well:χ2/df=3.757,GFI=0.988,AGFI=0.967,CFI=0.992,RMSEA=0.056,SRMR=0.0154.The path coefficient showed that psychological contract breach played a partial mediating role in nurses’overqualification,surface acting,and emotional expression requirements,with the effect values of 0.158 and 0.129,respectively,and the effect proportions of 53.12%and 65.78%;It plays a completely mediating role in nurses’ overqualification and deep acting,with an effect value of-0.119 and an effect proportion of 100%.The Bootstrap method(5000 repeated samples)was used to test the intermediary effect,and the 95%confidence interval did not include 0,indicating that the intermediary effect was significant.3.Qualitative interview of emotional labor experience of nursesThe results of qualitative interviews with 17 clinical nurses showed that nurses tended to generate emotional labor at work,adopted different emotional coping styles,and had different emotional management demands.Nurses’ emotional labor experience and demands were extracted from a total of three themes:cognitive feelings of work emotions(heavy occupational stress,cognitive gaps with work objects),selection of emotional coping styles(proactive coping,emotional expression camouflage),and expectations and demands of emotional management(knowledge and application needs of emotional management,and desire for emotional support).Conclusions1.The level of emotional labor among clinical nurses was above the medium level.Working years of current department,job objectives,career orientation and planning,psychological contract breach,and overqualification were the influencing factors of emotional labor among nurses.Managers should take targeted measures to intervene for improving the ability of emotional labor among nurses and promoting the quality of nursing timely.2.Psychological contract breach played a partial mediating role in the surface acting,emotional expression requirements of emotional labor and overqualification,and a complete mediating role in the deep acting of emotional labor and overqualification.Managers could assess the level of overqualification among nurses,improve their psychological capital and collectivism,correct negative perceptions of nurses,improve their salaries,optimize their promotion mechanisms,so as to reduce the psychological contract breach of nurses,promote emotional management behavior of nurses,and optimize their nursing service.3.Nurses could generate emotional labor,and their expectations and demands for emotional management increased.Managers should actively pay attention to emotional labor of nurses,formulate targeted measures to intervene timely and improve emotional labor ability of nurses for meeting their needs of emotional management,and improving the service quality of nursing.